. srerer? eueuc euanomnsnip ornce {337.5% t0 in Professional Guardian Registration Form p; FL 10 13 i. SFGU This re istration acka is: New Annual Amended Please ck 9 9 El Cl El (twig 030.103 - . . i {saggy moressionm GUARDIAN Last Name: 5 191/ l? 22L First: 2 23-15:! M1: DOB Business Address: ?557/ 51/1 6 194? . 1 City: 47?44/7775 State: Zip: .3 E-Mail: 56W Handle HS 697 40419141?!? *Social Security No; Phone: J7 15,75 7/2? '72 Fax: 4?3 Corporate Name (if applicable): Please indicate which counties you practice Q/m ?6?de 477.56??! - - Documents Please check one Clerk to send On ?le with SPGO/obtained within last 5 years ECompleted electronically FDLE Clerk to send On ?le with SPGO/obtained within last 2 years Etompleted electronically Credit El Clerk to send On ?le with SPGO/obtained within last 2 years Attached is required every ?ve years unless you were ling erprin red electronically and FDLE is retaining your prints. OLE is required every two years unless you were ?ngerprin ted electronically and FDLE is retaining your prin ts. Credit histories are required every two years. 40-Hour Professional Guardian Course Certi?cate of Completion Attached (please Check one) Name of Course and Date Completed: Yes ?le Contin uing_Edu cation Credits 16 SPGO approved continuing education credits are required every two-calendar years after completion of the 40- hour course. Please refer to the chart below: Year Course completed in 1999 or earlier 2006-2007 (due 2008) 20002009(due 2010) Course completed in 2000 2007?2008 (due 2009) 2009-201 0 (due 201 1) Course completed in 2001 2006?2007 (due 2008) 2008-2009 {due 2010) Course completed in 2002 2007-2008 (due 2009) 2009-2010 (due 201 i) Course completed in 2003 2006?2007 (due 2008) 2008-2009 (due 20? 0) Course completed in 2004 2007?2008 (due 2009) 2009-201 0 (due 201 1) Course completed in 2005 2006?200? (due 2008) 2008-2009 (due 2010) Course completed in 2006 2007 2008 (due 2009) 2000 2010 (due 2011) Course completed in 2007 2008 2009 {due 2010) 2010-2011 (due 2012) Course completed in 2008 2009 2010 (due 2031) 201 1-2012 (due 2013) Course completed in 2009 2010 - 2011 (due 2012) 2012-2013 (due 2014) Course completed in 20i0 20H - 2012 (due 2013) 2013?2014 (due 2015) DOENSPGO Form 001 November 2008 Page 1 of 4 9/59?; 2" Er} Co?tinumo ducation Courses Date Completed of Credits rem/mom 1.4a Silidi?id D/Wn'l 5/4/16 4? Ira/mo 1% ism/r r27 rim/a Jl//97/( fer/M x?Jm/zc, I g/x?/zf 457/ ?air/?aw {Fairs Z, {?mdxans?ry is?; raised 5 z; - - .mr/s (Please check-one)? ?Mb?umwm Date of Examination: )7 EP/?issed DSPGO waived my exam on (date of waiver) {Eggs}? smelter FIDUCIARY some Name of Bonding Company: 2TH i 13 C10 . Amount: 5 :50 W: Bond Anniversary Date: I I lb 35/ Bonds must be payable to the Governor and his or her successors in of?ce. Proof of renewal is required for annual registrants. First time registrants must attach a copy of your bond. STAFFING .1 )Please list each professional uardian employed (attach additional sheets if necessary). For each professional guardian listed above, you must submit a professional guardian employee registration form Form 002). All forms must be submitted together; do not submit your form without all your professional guardian employees?forms. Other employees with ?duciary responsibilities 4 Please complete the sectionis) below for each employee, other than professional guardians, that has a ?du? ciary responsibility to wards. Fiduciary responsibility is de?ned as having a position of trust. Last Name: First: Mi: DOB: Business Address: City: State: Zip: E?Mail: *Social Security No: Phone: Fax: Documents Date Submitted Please check one Clerk to send ?le with SPGO/obtained within last 5 years DCompleted eiectronicaily FDLE Cierk to send ?le with SPGOlobtained within last 2years DCompieted electronically credit Clerk to send On ?le with SPGOIObtained within last 2 years Last Name: First: MI: DOB: Business Address: City: State: - Zip: E?Mail: *Social Security No.: Phone: Fax: Form 001, November 2008 Page 2 of 4 l. I Documents Date Submitted Please check one Cierk to send ?le with SPGO/obtained within last 5 years Bfompleted electronically FDLE Clerk to send On ?le with SPGO/obtained within last 2 years B?mpleted electronically 09d" Clerk to send ?le with SPGO/obtained within last 2 years Last Name: First: Ml: DOB: Business Address: City: State: Zip: E?Mail: *Social Security No; Phone: Fax: Documents Date Submitted Please check one Clerk to send ?le with SPGO/obtained within last 5 years Completed electronically FBI FDLE Clerk to send ?le with SPEC/obtained within last 2 years El Completed electronically Clad? Clerk to send Den ?le with SPEC/obtained within last 2 years Last Name: First: Ml: DOB: Business Address: City: State: Zip: mm E-Mail: *Social Security No; Phone: Fax: Documents Date Submitted Please check one re: Clerk to send Den ?le with Spec/obtained within iast 5 years Compieted electronically FDLE Clerk to send ?le with SPEC/obtained within last 2 years Completed electronically Clad" Cleric to send ?le with SPGO/obtained within lastZ years is required every live years unless you were electronically and PM Is retain.i your prints. FDLE is required every twa years unless you were erprinted eiectronicaibr and FDLE is retain n9 your prints. Credit histories are required every two years. FEES Registration Fees 5. Number of professional guardians registering b. Registration Fee $35.00 Total Registration Fees (multiply lines a and b) 35?, ?ts? Expedited Processing Fees (optional) Registrations are processed within 30 days of receipt. if you opt for expedited processing, please choose one of the following: a. For expedited processing within 14- days $45.00 b. El For expedited processing within 7 days $55.00 c. For expedited processing within 48 hours $65.00 d. Number of professional guardians registering e. Total Processing Fees (multiply line a, b, or by line d) if Total Fees Due a. Total Registration Fees from 61 b. Total Expedited Processing Fees from 62 (if applicable) c. Total Fees Due (Add lines a and b) 5 Please enclose a check for this amount made payable to the Statewide Public Guardianship Of?ce Form 00!. November 2008 Page 3 of 4 that my ans? nd all statements made by me herein are true and correct. Please submit this form along wi all fees to: Statewide Public Guardianship Of?ce, Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, FL 32399-7000. KPPLICRNT STATEMENT: decl SIGNATURE: FBI Resulk hm: . I. Status. Status: Status: Status: ?9 . . Reviewer lnnl-.. Reviewer Initia? Reviewer Initial Date Reviewed: a . Date Date Reviewezl Date Reviewed BondExp ti (a C?UDueDate= 36?195 Status: 8 Status; 0 I (I) Reviewer Initla Reviewer initials: 5% Date a Date Date Entered into CE Broker: *The collection ofsocia! security numbers for record keeping is mandatory pursuant to Section 744. 1083, F5, and wiil not be available to the gen era! pubiic. Form 001. November 2008 Page 401?: STATL roe PUBLIC GUARDIANSHIB org a use I or ELDER "Agrees This registration package is: New [E/Annual El Amended (Please check 050130 539943;: PROFESSIONALGUABDM uncommon .- 110:2 lift 9: 09 l, 54 Last Name: 5/4 7?7" First; LIZ 5 53" Business Address: 527/ Dr . . I - City: 75?5 State: Zip: E-Mail: Mini ff?eeml?am Phone: 52/- Fax; 529/- Lise-2725? *Social Security No: Corporate Name (if applicable): Please indicate which counties you practice fix/.24 /3fe-KJ 5/2722,? - Documents Please check one I I Clerk to send [Ewen ?le with SPGO/obtained within last 5 years Completed electronically FDLE Clerk to send "On ?le with SPGOiobtained within last 2 years Completed electronically Credit Clerk to send [3/911 ?le with SPGOr'obtained within last 2 years Attached Bi is required every five years uniess you were 0er erprinred eiectronicailyond FDLE is retaining your prints. DLE is required every two years unless you were ?ngerprinted electronically and FDLE is retaining your prints. Credit histories are required every two years. 40-Hour Professional Guardian Course Certi?cate of Completion Attached {pleasech eckone) Name of Course and Date Completed: Pie F653 A 0-1 firmed wt rt {he 94" Aer/M. Yes [@611 ?le 750154147 (foam jail] 51.91:, Continuing Education Credits W, 16 SPGO approved continuing education credits are required every two-calendaryears after completion of the 40- hour course. Please refer to the chart below: Course completed in 1999 or earlier 2006?2007 (due 2008) 2008-2009idue 2010) Course completed in 2000 2007?2008 (due 2009) 2009?2010(due 201 1) Course completed in 2001 2006?2007 (due 2008) 2008?2009 {due 2010) Course completed in 2002 20072008 (due 2009) 2009?2010(due 201 1) Course completed in 2003 2006-2007 {due 2008) 2008?2009 [due 2010) Course completed in 2004 20072008 (due 2009) 2009?2010(due 201 1) Course completed in 2005 2006-2007 (due 2008) 2008v20091due 2010) Course completed in 2006 2007 2008 (due 2009) 2009? 2010 {due 2011) Course completed in 2007 2008 - 2009 (due 2010) 2010-201 1 (due 2012) Course completed in 2008 2009 20101due 2011) 2011?20121due 2013) Course completed in 2009 2010 - 2011(due 2012) 20122013 (due 2014) Course completed in 2010 2031 -2012 (due 2013) 2013-2014 {due 2015) DOE NSPGO Form 001 November 2008 Page 1 of 4 Continuino Education Courses Date Completed of Cred its check Date of Examination: BID/assed DSPGO waived my exam on (date of waiver) - Name of Bonding Company: {?15 . Amount: jl?v??r Bond Anniversary Date: 3/ cg?/C/ Bonds must be payable to the Governor and his or her successors in of?ce. Proof of renewal is required for annual registrants. First time registrants must attach a copy of your bond. if?) Please list each professional guardian employed [attach additional sheets if necessary). For each professional guardian listed above, you must submit a professional guardian employee registration form Form 002). All forms must be submitted together; do not submit your form without all your professional guardian employees?forms. {1321:} Other employees with ?duciary responsibilities Please complete the section(s) below for each employee, other than professional guardians, that has a ?du- ciary responsibility to wards. Fiduciary responsibility is de?ned as having a position of trust. Last Name: First: MI: DOB: Business Address: City: State: Zip: E?Mail: *Social Security No: Phone: Fax: Documents Date Submitted Please check one El Clerk to send [10:1 ?ie with SPGOfobtained within iast 5 years Completed electronicain FDLE El Cierk to send ?ie with SPGOfobtain-ed within last 2 years Completed electronically Credit Cierk to send 1:]0n ?le with SPGOr?obtained within East 2 years Last Name: First: MI: DOB: Business Address: City: State: Zip: E?Mail: *Social Security No: Phone: Fax: DOE Form 001, November 2038 Page 2 of 4 5 Documents Date Submitted Please check one FBI Clerk to send ?le with SPGOXobtained within last 5 years Completed electronically FDLE [j Clerk to send [Ebro ?le with SPGOr?obtalned within last 2 years ompieted elec tronicaily 09d? Clerk to send gin ?le with SPGOXObtained within last 2 years Last Na me: First: Ml: DOB: Business Address: City: State: Zip: E?Mall: *Social Security No: Phone: Fax: Documents Date Submitted Please check one Cleric to send ?le with SPGOJobtained within last 5 years Completed electronically FBI Clerk to send D011 ?le with SPGO/obtained within last 2 years DCompleted electronically 09d? Clerk to send ?le with SPGOlobtained within last 2 years Last Name: First: Ml: DOB: Business Address: City: State: Zip: E-Mail: *Social Security No: Phone: Fax: Documents Date Submitted Please check one Clerk to send ?le with SPGorobtaine-d within last 5 years Completed electronically FDLE Clerk to send file with SPGOXobtained within last 2 years DCompleted electronically Ciedli [j Clerk to send D011 file with SPGO/obtained within last 2 years r's req urred every ?ve years unless you were fl earrinted electronically and FD: is retaining your prints. FDLE is required every two years unless you were electronically and FDLE is retaining your prints. Credit histories are required every two years. Registration Fees a. Nu mber of professional guardians registering $35.00 b. Registration Fee c. Total Registration Fees (multiply lines a and b) (EEC: Expedited Processing Fees (optional) Registrations are processed within 30 days of receipt. if you Opt for expedited processing, please choose one ofthe fo wing: a. For expedited processing within 14 days $45.00 b. For expedited processing within 7 days $55.00 c. For expedited processing within 48 hours $65.00 I d. Number of professional guardians registering I e. Total Processing Fees (multiply line a, b, or by line d) 2 i Total Fees we a. Total Registration Fees from 61 b. Total Expedited Processing Fees from 62 (if applicable) c. Total Fees Due (Add lines a and b) Please enclose a check forthis amount made payable to the Statewide Public Guardianship Of?ce i Form Gal, November 2008 Page 3 of 4 ill STATEMENT: declare that ansv'sfgl'? nd all statements made by me herein are true and correct. fix/my DATE: $5 Please submit this form along with all fees to: Statewide Public Guardianship Of?ce, Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, 32399?7000. . FDLE Results Date: Crediteesuzts Oat Results Date Status: Status:. Status; .. Reviewerlniti: Reviewertnitiais Date Reviewed Date Reviewed: Bond Expiration Date: CEU Due Date: C236 vs Status: ., Status: Reviewetinitiais Rewe-wemnitials Date Reviewed: Date Reviewed; Date Entered into Broker: ?The coiiection ofsociai sew!in numbers for record keeping is mandatory pursuant to Section 744. 3083, ES .. and not be ovaiiabie to the gen eroi public. DOE NSPGO Form 031. November 2008 Page 4 of 4 PJELIC GIERDIANSHIP Proressional Guardian Registration Fort-L?! New Annual I [j Mg,le 2013 FEB EH lG= it This registration package is: PROFESSDNAL GUARDIAN INFORMATIQN .. . Last Name: 26;? First: 5 2,44 MI: Business Add ess: 447/)? ?irt . City: MM ?02 State; Zip; 5.101311; 5.62%; 7721 we?re/fans *Social Security I - Phonezle/J75 7573 Fax: (jg/4242;! MM 45'5"? Corporate Name (if applicable): I EIN: 2. Please indicate which counties you practice 2. Documents? Airing?lyease check one I I I FBI I [j Clerk to send @631 ?le with SPGO/obtained within last 5 years Completed electronically FDLE [j Clerk to send W?le with SPEC/obtained within last 2 years Completed electronically Credit Clerk to send E?n ?le with SPEC/obtained within last 2 years Attached is required every ?ve years unless you were ?ngerprinted ectronicaliy and FDLE is retaining your prints PM is requrred every two years unless you were ?ngerprinted electronically and FDLE is retaining your prints. Credit histories are required every two years. ~mswamemtw. . 40-Hour Professronal Guardian Course Certi?cate of Completion Attached (please check one) Na mgngurse and Date Completed: . Yes Eda ?le M??t a a; 3525; C??tmumg Education Credits on of the 40- 16 (30 approved contmumg educatlon credits are requrred every two-calendar years after completi our course. Please refer to the chart below: - 97-4? hourPrefes510.0a..l..?uardsan Course completion?.- .. COWSE tSOFTiliileted in 1999 or earlier 200642007 (due 2008) 2008?2009(due 2010) 2007-2008 (due 2009) 2009-2010 (due 201 1) Coursecogeted in 2000 Course compteted in 2001 2006100? (due 2008} ZOOBQOOQ (due 2010) course comp?m?i i" 2002 2007-2008 (due 2009) 2009-2010 (due 201 1) Course completed in 2003 I 2006-2007 (due 2003) 2008-2009 (due 2010) 22:3: 2? :33: :i 2007?2008 (due 2009) 20092010 (due 2011) Course co?mpiemd i: 2006 2006-2007 (due 2008) 2003-2009 [due 2030) Course crammed in 2007 2007 - 2008 (due 2009) 2009- 2010 (due 201 1) Course completed in 2008 2008 - 2009 (due mm) 20192011 (due 201.2} Course; compieted in 2009 2009 - 2010 (due 2011) 2011-2012(due 2013) Course completed in 2010 1 2010' 2011 (due 2012) 2012-2013 (due 2014) 20:1 - 2012 (due 2013) 2013~20141due 2015) Form 001. Novrember 2008 Page 1 of 4 Date Completed of Credits a Continuing Education Courses f? 3. km?! 41/5/45 st ?y?eea?nb/ ?a?/J/fm hrs/Zebu 7356/? {fins/fwd" uj?f'l?tn? {Li/7,1 Fri/Wilma {Kat-?55 Z. Wat/fey $23415 r456?: ??af 574/? lag/Mtg 5/ we Wee . g) one) -- Date of Examination: VML E'P/assed DSPGO waived my exam on (date of waiver) Name of Bonding Company: :70! f? 1.6 Amount: 577: a Bond Anniversary Date: 3/5/I/r 3 Bonds must be payable to the Governor and his or her successors in of?ce. Proof of renewal is required for annual registrants. First time registrants must attach a copy of your bond. @Please list each professional guardian employed (attach additional sheets if necessary). For each professional guardian listed above, you must submit a professional guardian employee registration form Form 002). All forms must be submitted together; do not submit your form without all your professional guardian employees'forms. Other employees with ?duciary responsibilities Please complete the section(s) below for each employee, other than professional guardians, that has a ?du? ciary responsibility to wards. Fiduciary responsibility is de?ned as having a position of trust. Last Name: First: Ml: DOB: Business Address: City: State: Zip: E-Mail: *Social Security No.: Phone: Fax: Documents Date Submitted Please check one Clerk to send ?le with SPEC/obtained within last 5 years Completed electronicaliy FDLE Clerk to send ?le with SPGOIobtained within last 2 years Completed electronicaliy CTE?dit Clerk to send ?ie with SPGO/obtained within last 2 years Last Name: First: Ml: DOB: Business Address: City: State: Zip: E-Mail: *Social Security No.: Phone: Fax: Form 001, November 2008 Page 2 of 4 Documents Date Submitted Please check one Clerk to send ?le with SPGO/obtained within last 5 years [3 Completed electronically FDLE Clerk to send On ?le with SPGO/obtained within last 2 years Completed electronically Credit Clerk to send Last Name: Business Address: 5x5? 793'? Ala?: 574 City: :77? BM 6% State: Zip: E-Mail: *Social Security No.: Phone: Fax: Documents Date Submitted Please check one El Clerk to send ?le with SPGO/obtained within last 5 years [3 Completed electronically FBI FDLE Clerk to send ?le with SPGO/obtained within last 2 years '3 Completed electronically Credit El Clerk to send ?le with SPGO/obtained within last 2 years Last Name: First: MI: DOB: Business Address: City: State: Zip: E-Mail: *Social Security No.: Phone: Fax: Documents Date Submitted Please check one FBI Clerk to send ?le with SPGO/obtained within last 5 years DCom pleted electronically FDLE Clerk to send ?le with SPGO/obtained within last 2 years DCom plated electronically Credit Clerk to send ?le with SPEC/obtained within last 2 years is required every ?ve years unless you were ?n erprin ted electronically and FDLE is retaining your prints. FDLE is required every two years unless you were ngerprinted electronically and is retaining your prints. Credit histories are required every two years. tats. Registration Fees a. Number of professional guardians registering b. Registration Fee $35.00 c. Total Registration Fees {multiply lines a and b) Expedited Processing Fees (optional) Registrations are processed within 30 days of receipt. if you opt for expedited processing, please choose one of the following: a. For expedited processing within 14 days 545.00 b. El For expedited processing within 7 days $55.00 c. For expedited processing within 48 hours $65.00 d. Number of professional guardians registering . . . . ?7 2' r? e. Total Processmg Fees (multiply line a, b, or by lrne d) 3.5.. Total Fees Due a. Total Registration Fees from 5 6? b. Total Expedited Processing Fees from 62 (ifapplicable) I c. Total Fees Due (Add lines a and b) . Please enclose a check for this amount made payable to the Statewide Public Guardianship Of?ce Form 001, November 2008 Page 3 of 4 APPLICANT STATEMENT: :1ng3/ answers and all statements made by me herein are true and correct. APPLICANT SIGNATURE: If DATE: Please submit this form along with all fees to: Statewide Public Guardianship Of?ce, Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, FL 32399?7000. Credit Date: FBI Resu sDate: FDLE Rem?- nate: . Exam/W er Date: Status: Status:. Status: Statusg?! Reviewer?titialsih: Reviewer'lnitial. Reviewerlnitialsz. Reviewerlnitials; ?33 Date Reviewed: Date Reviewed: Date Reviewed: - Date Reviewed: l' Bond ExpiratiogBate: 9? 5? 1 CEU Due Date: Status: Status: A i Reviewer Initials: B73 Reviewer initials: E3 Date Reviewed: 2' i 3 Date Reviewed: ii a i l, Date Entered into CE Broker: *The collection of social security numbers for record keeping is mandatory pursuant to Section 744. l083, 55., and will not be available to the general public. #7 93M MM Waller at Eet?gni? Qae?ntma?ae? (Lee?ta Rwae, penned gig-rifle, ales/re were Form 001, November 2008 Page 4 of 4 . .: eueuc GUARDIANSHIP a. . Professional Guardian Registration Form This registration package is: New E?Annual Amended (Please checkone) it} PROFESSIONAL GUARDIAN INFORMATION gays-y LastName: First: Edie/M: Ml: i DOB: 7 7 ~57 Business Address: All/67? 45% 57L: I City; [751? /f4 1/ jaw/A State; .- z?p; 3 5/50,? Ema?; 3671/! 272; n5 . 6 W19 law?? *Social Security No.: Phonei?sz? ?zz ?g F3953 746 ?537 Corporate Name (if applicable): E1131: Please indicate which counties you practice 6 )4 65166;? Documents Please check one I El Clerk to send [26n ?le with SPGO/obtained within last 5 years Completed electronically FDLE El Clerk to send [20h ?le with SPGO/obtained within last 2 years Completed electronically Credit Clerk to send @On ?le with SPGO/obtained within last 2 yea rs ?3 Attached is required every ?ve years unless you were ?ngerprinred electronically and DLE is retaining your prints. FDLE is required every two years unless you were ?ngerprinted electronically and FDLE is retaining your prints. Credit histories are required every two years. 2032? Fire: 3 rijg?f?E?ED "i 40-Hour Professional Guardian Course Certi?cate of Completion Attached (please check one) Name of Course and Date Completed: ETes On ?le Continuing Education Credits 16 SPGO approved continuing education credits are required every two-calendar years after completion of the 40- hour course. Please refer to the chart below: Yea or 40-hour Course completed in 1999 or earlier 2006-2007 (due 2008) 2008-2009(due 2010) Course completed in 2000 2007?2008 (due 2009) 2009?2010 (due 201 1) Course completed in 2001 2006?2007 (due 2008) 2008-2009 (due 2010) Course completed in 2002 2007-2008 (due 2009) 2009-2010 (due 201 1) Course completed in 2003 2006-2007 (due 2008) 2008?2009 (due 2010) Course completed in 2004 2007?2008 (due 2009) 2009?201 0 (due 201 1) Course com pieted in 2005 2006-2007 (due 2008) 2008?2009 (due 2010) Course completed in 2006 2007 - 2008 (due 2009) 2009- 2010 {due 2011) Course com pieted in 2007 2008 - 2009 (due 2010) 2010-2011 {due 2012) Course completed in 2008 2009 2010 (due 2011) 201 1?2012 (due 2013) Course completed in 2009 2010 2011 (due 2012) 2012-2013 (due 2014) Course completed in 2010 2011 - 2012 (due 2013) 2013-2014 (due 2015) Form 001, November 2008 Page 1 of4 {Chit Continuing Education Courses lg Date Completed ii of Credits . . jg 421 km Mm; 557 a EXAMINATION (Please check one) Date of Examination: E?Passed DSPGO waived my exam on (date of waiver) BLANKET FIDUCIARY BOND Inv- ., want-n.4- q. Name of Bonding Company: 7M 5 2257 Amount: 5-5; .i Bond Anniversary Date: '5 3 Bonds must be payable to the Governor and his or her successors in of?ce. Proof of renewal is required for annual registrants. First time registrants must attach a copy of your bond. @Please list each professional guardian employed (attach additional sheets if necessary). For each professional guardian listed above, you must submit a professional guardian employee registration form Forrn 002). All forms must be submitted together; do not submit your form without all your professional guardian employees?forrns. Other employees with ?duciary responsibilities Please complete the sectionls) below for each employee, other than professional guardians, that has a ?du- ciary responsibility to wards. Fiduciary responsibility is de?ned as having a position of trust. Last Name: First: MI: DOB: Business Address: City: State: Zip: E?Mail: *Social Security No.: Phone: Fax: Documents Date Submitted Please check one Clerk to send ?le with SPGO/obtained within last 5 years I: Completed electronically FDLE Clerk to send ?le with SPGO/obtained within last 2 years El Completed electronically C?E?dit El Clerk to send ?le with SPGO/obtained within iast 2 years Last Name: First: MI: DOB: Business Address: City: State: Zip: E-Mail: Phone: Fax: *Social Security No.: DOENSPGO Form 001, November 2008 Page 2 of4 Documents Date Submitted Please check one Clerk to send ?le with SPGO/obtained within last 5 years Completed electronically DLE Clerk to send On ?le with SPGOXobtained within last 2 years DCompleted electronically Credit Clerk to send ?le with Spoorobtained within last 2 years Last Name: First: MI: DOB: Business Address: City: State: Zip: E-Mail: *Social Security No.: Phone: Fax: Documents Date Submitted Please check one Clerk to send ?le with SPGOIobtained within last 5 years DCornpieted electronically FBI FDLE Clerk to send ?le with SPEC/obtained within last 2 years [3 Completed electronically Cmdl?f Clerk to send ?le with SPGO/obtained within last 2 years Last Name: First: MI: DOB: Business Address: City: State: Zip: E-Mail: *Social Security No.: Phone: Fax: Documents Date Submitted Please check one FBI El Clerk to send ?le with SPGO/obtained within last 5 years EICompleted electronically FDLE Clerk to send ?le with SPGOfobtained within last 2 years I: Completed electronically 09d? [j Clerk to send ?le with SPEC/obtained within last 2 years is required every ?ve years unless you were ?ngerprinted eiectronicaily and FDLE is retaining your prints. FDLB is required every two years unless you were ngerprin ted eiectronicaii?r and F015 is retaining your prints. Credit histories are required every two years. riggionf?.) TEES Registration Fees a. Number of professional guardians registering b. Registration Fee $35.00 c. Total Registration Fees (multiply lines a and b) Expedited Processing Fees (optional) Registrations are processed within 30 days of receipt. if you opt for expedited processing, please choose one of the following: a. For expedited processing within 14 days $45.00 b. El For expedited processing within 7 days $55.00 c. For expedited processing within 48 hours $65.00 d. Number of professional guardians registering e. Total Processing Fees (multiply line a. b, or byline d) 5 1:63.} Total Fees Due a. Total Registration Fees from 61 5 b. Total Expedited Processing Fees from 62 (if applicable) 5 c. Total Fees Due (Add lines a and b) Please enclose a check for this amount made payable to the Statewide Public Guardianship Of?ce Form 001. November 2008 Page 3 of 4 I i APPLICANT STATEMENT: declare that my answequ all statements made by me herein are true and correct. APPLICANT SIGNATURE: QM ?aw DATE, ,3 A 1 Please submit this form along with all fees to: Statewide Public Guardianship Of?ce, Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, FL 32399-7000. Credit Results Date: FBI Results Datr FDLE Results Date: . Exam/Waixfi?ate: Status: C: Status: Status: I Status: Reviewerlnitials? Reviewer initials: .e Reviewerinitials: Reviewer lgitialsu?L Date Reviewed: . Date Reviewed: 3ate Reviewed: fDate Reviewed: (A a ?1 .n Bond Expiration Date: "31- CEU Due Date: 2517 if? Status: 1 Status: Reviewer initials: Reviewer lnitials: Date Reviewed: ?4 ?75l Date Reviewed: 4 4? is? i Date Entered into CE Broker: i *The collection ofsociol security numbers for record keeping is mandatory pursuant to Section 744. l083, ES, and will not be available to the general public. Form 001, November 2008 Page 4 of 4 - - . Puauc GUARDIANSHIP Professional Guardian Registration Form ?l-r-Il am This registration package is: MNew El Annual [j Amended (Please check one) PROFESSIONAL GUARDIAN 003: eg- 2511.: ?Wam-? Mum-w? Last Name: 7 'First: 5129/? 25/4 Business Address: I MW 5.0 79m #4 1?3 City: l/ [376/1 State: Zip: 2. 2 72 E-Mail: #512104? fir/Mn I . - . Mm *Soc1al Security No.: phone; 152(351?23 (g 2; Fax; 5 ?g .. {55:1 Corporate Name (if applicable): Please indicate which counties you practice 2,6515% E55775 Ml: Documents I Please! check one I I I Clerk to send On ?le with SPGO/obtained within last 5 years Wompleted electronically DLE Clerk to send On ?le with SPGO/obtained within last 2 years Com leted electronically Credit El Clerk to send On ?le with SPEC/obtained within last 2 years We'd is required every ?ve years?unlessyou Were ?ngerprint'ed electronically and FDLE is retaining your prints. FDLE is required every two years unless you were ?ngerprinred electronically and FDLE isretoining your prints. Credit histories are required every two years. 40?Hour Professional Guardian Course Certi?cate of Completion Attached (please check one) Name of Course and Date Completed: Frail. ?w?rxAmirsAf/i [27501614 Yes A ?le 5? it?! 1 8? . . w: Mia 52.} Continuing Education Credits 16 SPGO approved continuing education credits are required every two-calendar years after completion of the 40- hour course. Please refer to the chart below: Course completed in 1999 or earlier 2006?2007 (due 2008) 2010) Course completed in 2000 . . . .. . . 2007?2008 (due 2009) 2009-2010 (due 20'! 1) Course completed in 2001 2006-2007 (due 2008) 2008-2009 (due 2010) Course completed in 2002 2007-2008 (due 2009) 2009-2010(dge201 1). Course completed in 2003 20002007 (due 2008) 2008-2009 (due 2010) Course completed in 2004 2007-2003 (due 2009) 2009-201 0 (due 20} 1) Course completed in 2005 2006-2007 (due 2008) 2003-2009 (due 2010) . Course completed in2006 - 2007 - 2008 (due 2009) 2009- 2010 (due 201 1) Course completed in 2007 2008 7.20.09 (due 2010) . 201-0r2-011-(due 2012) - Course completed in 2008 2009 A 2010 (due 201 1) 2013) Course completed in 2009 2010 - 2011 (due 2012) 2012-2013 (due 2014) Course completed in 2010 2011 - 2012 (due 2013) Form 001, November 2008 Page 1 of 4 (at) Continuino Education Courses Date Completed ii of Credits {see-nae?) EXAMINATION (Please check one) Date of Examination: Eifassed DSPGO waived my exam on (date of waiver) Name of Bonding Company: W6 Amount: 5 5?0, 575% Bond Anniversary Date: Mir/5% 3/ :70 ?7 Bonds must be payable to the Governor and his or her successors in of?ce. Proof of renewal is required for annual registrants. First time registrants must attach a copy of your bond. F1. )Please list each professional guardian employed (attach additional sheets if necessary). For each professional guardian listed above, you must submit a professional guardian employee registration form Form 002). All forms must be submitted together; do not submit your form without all your professional guardian employees?forrns. Other employees with ?duciary responsibilities Please complete the section(s) below for each employee, other than professional guardians, that has a ?du- ciary responsibility to wards. Fiduciary responsibility is de?ned as having a position of trust. Last Name: First: MI: DOB: Business Address: City: State: Zip: E-Mail: *Social Security No.: Phone: Fax: Documents Date Submitted Please check one FBI Clerk to send ?le with SPGO/obtained within last 5 years DCompieted eiectronically FDLE Clerk to send On ?le with SPGO/bbtained within last 2 years Completed electronically 09d? Clerk to send ?le with SPGO/obtained within last 2 years _ast Name: First: Ml: DOB: iusiness Address: :ity: State: Zip: E?Mail: Social Security No.: Phone: Fax: up Form 001, November 2008 Page 2 of 4 Documents Date Submitted Please check one FBI El Clerk to send ?le with SPEC/obtained within last 5 years [3 Completed electronically FDLE El Clerk to send ?le with SPEC/obtained within last 2 years El Completed electronically Clem? El Clerk to send ?le with SPGOIobtained within last 2 years Last Name: First: Mi: DOB: Business Address: City: State: Zip: E-Mail: *Social Security No.: Phone: Fax: Documents Date Submitted Please check one El Clerk to send ?le with SPGO/obtained within last 5 years DCompleted electronically DLE El Clerk to send Eloh ?le with SPGO/obtained within last 2 years El Completed electronically credit Clerk to send ?le with SPGO/obtained within last 2 years Last Name: First: MI: DOB: Business Address: City: State: Zip: E-Mail: *Social Security No.: Phone: Fax: Documents Date Submitted Please check one Clerk to send ?le with SPGOXobtained within last 5 years El Completed electronically FDLE Clerk to send ?le with SPGO/obtained within last 2 years El Completed electronically 09d? Clerk to send ?le with SPGO/obtained within last 2 years FBI is required every ?ve years unless you were ?ngerprin ted electronically and F015 is retaining your prints. FDLE is required every two years unless you were ngerprin ted electronically and FDLE is retaining your prints. Credit histories are required every two years. FEES :E?lsa Registration Fees a. Number of professional guardians registering 535.00 b. Registration Fee c. Total Registration Fees (multiply lines a and b) '5 5" :36? Expedited Processing Fees (optional) Registrations are processed within 30 days of receipt. if you opt for expedited processing, please choose one of the following: a. El For expedited processing within 14 days $45.00 b. For expedited processing within 7 days $55.00 c. Elfor expedited processing within 48 hours $65.00 d. Number of professional guardians registering e. Total Processing Fees (multiply line a, b, or by line d) 5 Total Fees Due a. Total Registration Fees from 61 5" "l b. Total Expedited Processing Fees from 62 (if applicable) 5 c. Total Fees Due (Add lines a and b) S1267 . ?70 Please enclose a check for this amount made payable to the Statewide Public Guardianship Of?ce 8'3? 26 201i era-i 3; ii Form 001, November 2008 Page 3 of4 APPLICRNT STATEMENT: I declare that my answers and all statements made by me herein are true and correct. - . . 4:73?92 5? 832:7 I . Ar; Please submit this form along with all fees to: Statewide Public Guardianship Of?ce, Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, FL 32399?7000. Credit Results Bate: 44 Results Date:_ ResultsDate:. Status: Status: "?Status: Reviewerlnitials: ?5 Reviewer Reviewer initials: 6* Date Reviewed: El Date Reviewed: Date Reviewed: Date ReviewedBond Expiration Date: CEU Due Date: 2} Status: Status: Reviewerlnitials: U5 Reviewerlnitials: k?Dk Date Reviewed: w? h} Date Reviewed: 1252,10? Date Entered into CE Broker: *The collection of social security numbers for record keeping is mandatory pursuant to Section 744. 1083, ES, and will not be available to the general public. eat-ME are; a; 46:. he Lear??- . I i a raga {fit/{l W3- mm Form 001, November 2008 Page 4 of 4 RECEIVED DEPT. or ELDER AFFAIRS SPGO Guardians Etiaa hem etsy? 561 Country Club Er. Atlantis, FE. 33462 561-573-12QZ Fax ZUthfiR l2 ta 9= 09 3/5/14 Dear Statewide Public Guardianship Of?ce, My credit report has the same information it had last year. There is still an outstanding balance on mortgage as we are still negotiating the payoff with Citibank. They are held up because my loan is a heloc without a ?rst mortgage, and they are still backlogged with ?rst mortgages. Thank you again, ?ags: El?abeth Savitt 61f29/2814 86:35 RDSF Ell RECEWED DEPT. OF ELDER Savitt Probate and Guardianship '2 PH 1: 25 Elizabeth ?Betsy? Savitt 501 Country Club Dr. Atlantis, Fl. 33462 5616734292 Fax 551-439-6765 3/12/14 Statewide Public Guardianship Of?ce Attention Teresa Martin Fax 850-414-2384 BE: 85 ELIZABETH SAWT Report As Of: 311212014 mm of Comm Persantl Rayon summary Bankruptcy cow-i 4::di inquine . 0mm cam. Loans ?rmer new credit Score Eme?m 82 AFFAIRS 0m. EDIWAR 12 Fi? 3:25 15 16 chwdi?epomcom A Part of Expedan PAGE 83 85:85 561495?F~q1 RUSF ELIZABETH SAWT I ?73.12?an laport As Of: 31?1212014 - ww- Foraono! lnfamm?m lam you will ?nd yum pmonellntonno?on, including your legal namom, you: of birth, cumin! and previous address?, and worm: and previous ompbyers. 31:33 Experian Equ?eo Tmns?nion Ham El. NEW 5 SAWTT (Aha Know ELMETH some? your aim 1M5 AM) 501 Mcoummw WORTH, FL 334$qu ?01 LEAF GT. DELRRY 535 Ewmvjana?d Equjfax" and Leg In 3559?. FL 33445-1258 Tmmumnnacfemaspam and scores 43o no. KEY I a! a spools! ?Memo.? ow. pm! .3 What'o missing from this piotum? BBCAYNE, Fl. 331494339 3mm emanates I Pumas my" sou: EMHOYED l' .u . I . . Pomona! Statement WWL we lid-W ?mio space is rotemd for otatamomu oi dispute. For moo! coraumors, no Information appears In this see on. Naomi mfomuon?w 1 of! Report Summary Credit Inquires Cradit Card: 8. Loans . Credit Score 81f29f2814 25:5ch n?vm mm lera yuu wt? ?nd a smmaty oral! yum open and aims mad. Accow? totals, Including total debt. are fomd a 86:85 ELIZABETH SAVITT 551495?r*4 ?Hm Rapar? Summary ad accoumn. including anyde?nquamiss. Open account contain cumsnt balance: a! the time the (open we; {the and ofthia section. c?WJ?w nan-r- Ra?! Esmm Revolving Delinqu Accounus) r. Installmem Currant mun: Mm Cum: Dam;th mar Camn Want? Camus W- Go out ?lm Curr-on ?lbw?! um. Gaunt Balance can?! summon: Collec?ow . Currant mounts) Conn! Minna om: i Ali?ccounts Delinqu Accounla) On an? Balance Curr-n! Dem-mum? Omar imexperian? 5?13"? Hana-Union w) 55575.00 DOM 50.00 0 0 1 50.00 1 0 ??tl :{jfExpe?an? 1 7 $258,760.00 16 1 PAGE 94 ifg?kpa?an? REEF What'x missing tram Ella picture? Log In Now! 559 your Gunman", Equine a nd m?mi?hpanmm Tranwnion" Cmdit Reports and Scores a! a special "Mernbom Ora! price. .H n. Equ?ax TramUnmn I What's. missing this picture? . SM your Mariana, Eqmmx" and Log in Now! TransUniona Cmdit Reports and Scores at a specie! "Member-a plies. .ul Hr? .- Human-11v- .I. --. .. Persona! Information Bankruptcies Cred?Scom 813?29z?2814 BB: 5 5614935" 9.1 RUSF PAGE I35 il.? ELIZABETH SAVITT . {6331311 As or: 3/12/2014 3mm? Credit Score ourCndit Scone Is a numerical representation of your credit muf?is that is trend by most lander: and credit card issuers. Rcmomhor, Emotion, Equiiox and romUnlon has its om out of data in your crodit filo- ?that?s why Credit acorns may vary balwoon bureaus. In. What'u missing fnom this picarro? 1 See your Emotion". Boar-ax? and i'i owl Transmian Credit Roporto and Sooros ?m at a special "Members only? price. 334:3 Whirl: factor: ME you PLUG Boom: What factors PLUS Boom: a. Credit Cards a?ow you to both spend money and decrease debt; Missing payments is the most damaging thing you can do to your unliko mortgagor: orimtallmom loam Man you only decrease debi. credit. The purposo of a crodit more it to help lenders predict whether Lenders like to no muitipie mail cards on you credit report. or notyou will miss payments in tho Mono. no even a singia misaod became thay are able to use thorn to better dotsm?na your ability to payment can lower your were. manage your spending. a You now spent more than rail arms crodlt that has been ardendoo to . You do not have any Public Records (is, bankruptcies, tax irons, and you. and Isadora see this as a sign of imsponsibio credit behavior. court iudgmenta) on your "part. Lenders see these issues as ideally. you would pay o? your baianoos ovary month or at lanai kup major barriers to Intending addilionoi credit. your omdii?to-doht ratio mar 15%. i London use credit rooms: and orcdit mores to predict ?author or not A Every timer you apply ior a ioan, oradit card, or retail card oninquiryis you will most More iinanciaiobiigations. Having a longer credit history recorded on your credit report. Having a lot of Inquiries on your credit given them more information to ban thou prediction: on, and report worries tendon, baoause it is I sign tho: you may u? orodii their con?dence in you ovamii. and tom: to suppiarnont your income, and might be spending beyond your means. 1 When you have spam more than 90% at your available credit on a credit and. lenders perceive this as a sign that you are iiving offoi your crodit card: because your Income in not large enough to oowryour ?puma. This leads themto bellow that you might not in able to anon: the payments on More lines of credit. Pemomi information Report Summary Bankruptcies Credit Inquire! Credit Cards 5 Loans Crodit Boom Fm of! E16 1 ?29281 :1 as: 95 551495;?! 91 HOSP ELIZABETH SAVITT i? Report?w 01?: 3112/2014 ?m Gm?? Loans mh?r Dabt A Hera ynu Mil ?nd speci?c information on each account you Opened, including current status am any put due information- Posww credit information remains on your raw? Cmd?or comiciinfonm?on has been provided in ordano make it easier foer to anyissues. 1* '1 I In a WELLS FARGO BANK :53; Emma? [qu?ax mm Iransumon .1 Current Cloud Am? "m WELLS FARGO I sown? .. i Amount Tm Ema-ad Credit Card f1 500-642-4720 Baum I Fauna: What's mam this picture? PO Box 1451? DES MQIMES. am 60306 mm? Amni?ms Closed 1 393 551mm? and Log h: Haw! i TransUnion" Cmdii Reports and Scores m? "mm sm? at a specie! ?Membars Ow pace, High Baum $25.00 3 Limit 51.00090 rm Wm cm Milli mm bytmac?har 9 24M: Pamela: History 2010 201 2012 SEF OCT NOV DEC JAN FEB MAR APR HAY JUN JUL AUG SEP 051' NOV 1150 JAN MAR AFR MAY JUN JUL AUG Emrlm UK (31-: UK UK Fayment History Legend 0K Currant :m 39 Days Lam K0 Key 09mm? ND No Data? {it} $13 Buy: Law RF Wl??an or Formats 60 Days Late PP hymn! Plan 120 120 Days Um ?3 ometimaa the credit humans do nut haw Informatbn from a patioqu month on file. Fat nd?ltionai information on Key Damnahory, phase see yourCu-dn Report Guide. . man?F?. Account Steam Legend nun-.- IA w- MW -. Persona! Information Rnporismary Bankruptcies Credit mamas . Oman Cards 1: Loam WQ a? Crade Sm 81/29f2614 88:65 561495?- 91 ROSF PAGE ELIZABETH SAVITT Eli-imam Raped A: Of: 3f12l2014 Credit Saran, Leann Other Debt - - ?are you will ?nd apad?c infonna?on on each manual you opened, including current status and any pas! due lnfoma?m. Posi?w cwdit information remains on yaw upon inds?nitaly. Cmd?or contact infan'nation has been provided in ardent: make ?slur forwu to resolve anyiasuas. I I TH :ms?xpergan- Emma: IransUnion an- . Curran! Cloud mm Amount -. Amount we charge mm No Phone mm Baum i Pogox 3497 Pm Wh?t?? missing E133 ptcham? am Md 12532007 I SIOUX 57117 Cloud See wurman?an .Equ?ai" and P. m1 3 TransUniononedltRepn?s and scores I ?mm "a at a special ?Members any prince. mm $5901.00 1' I'm Roeru Cndit dosed-warm: mqwd- riparth byuhacribar 2w? Parnell History 2007 2008 2009 Mont: Jim JIJL AUG OCT NEW DEC JAN FEB MAR APR MAY JUN JIIL AUG SEP NOV DEC I JAE ?58 MR APR HAY Expe?m UK OK 0K 01VISDSNE :a:Egp9f?an' Equifsx NansUniun MmCum?! Ctosad Am"! Ham V?mm . . Alum:an Cindi! Cird I sown-6552 Winn $0.110 9m DUKE BLVD M: an What's missing from We plc?xre? MASON. OH 45040 Cloud 1 See, your Emma"? Eqwh? and Log In Now! Punk? m? CNN 5 TransUnion? Credit Reports and Scores my? Mm at a special'Memmrs Only? price. Lima 5330.00 "i Tm Romm Wish Crud}! line '5 ropon 5' 24m Paymm History 2009 2010 201 Mont: OCT NOV DEC JAR FEB MAR APR MAY JUN JIJL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY Jun JUL AUG 85? Emrmn OKPersonal Rayon Sumary Bankruptcies Credit human :-cm:1Cam Eu team Fm of?? I . 6mm Score 61f29f2814 85:35 5614955} 91 RDSF ?18 ELIZABETH SAvm ?mm aspen As or: 3112/2014 - Credit Came, Lama Other Debt sore you will ?nd speci?c infomtian on each account you opened. Including current status and anypast due information. Positive credit information remains on your man indo?nltaly. Creditor comset Infom?on has been provided in ordarto make it assist forynu to reserve anyissuss. mun 59mm 51,334.00 Um? rm Ran cm 13m chad-printar :0qu? mm by ?lumbar I II (aw. Current Cloud Am? "in" Fu-Rsmm Account at .I . . ,x 1 Am?: rm 0mm cm I 84mm 5 . P0 Pmnua What a missing from this picture? 801.6283 FALLS, so 5?11? mm A?u?Mt Cloud 33? you; Emu-gm?, Emma? and Lognln Mm! Tramumon" Credit as m? "cm" . . . pans and Scores ?mm pm ?ham? g} at a anemia! "Members OW prim. 5 241m Puma! limp} 2008 2007 2008 M000Exparlen (33SPACE ems? CREDIT um :13: Expan?an? {guitar YransUnian Cumm mend Amount Nam space cam cam? um Amunw 1 4mm rm Auto Loan 5 321452?222 it 8045 NW?:le an gun": 1; What?s missing from this picture? MELBOURNE FL 32940 mm? 1mm? a I - - emu Sea yuurEwerian ,Equ'la?and (-09 ?1 1 Ho. Pom-n! Crodil Ropa?s and Scores m? ?pnmm Pinyin-mt m: Paid. was putdus 30 Gaye at a special! ?Members Only? price. all!? i Tm nMom :2010 2911 2012 Month NOV DEC JAN FEE MM APR MAY JUR Jill. AUG SEPIOCT NOV DEC JAN FEB MAR APR MAY JUN JUL MIG SEP OCT Emma '12?Mn? Summ'v Bankruptcies 6mm: Inquires - Crew: cam Lama Paw 7 we Credit score almexzma 85:65 551493291 RUSF may; [39 r. ELIZABETH SAVITT i??exmw {sport As 01': 31212014 Credit C?r?a, Loam Gina? Debt 1am you will ?nd spacllic inlormailon on each accounl you opened, including current status and any past due infannah'on. Posi?w credit information mmalm on your apart lnde?nlmy. Creditor infunmllon has bean promdad In order to make it easier foryou to resolve COLLECTIOR RESU LTS INC :szxpefian' {calla TransUnian J. I I Amum Hm meow seems Current Closed - Anew-mm Attorney Bel-m i' mm?: What?s from this plctum? i MERFELI) emu FL 33442 Wm? mm? 5 CW 5 See yourEarparian", Emlme and U?ii 1? rt "mm TrlanalJrliona Credit R: my . ports and Scores puma-awn Palmmaaohn?onm, ?3 - a - imam! daim all: special Membm ow pace. om: urn-lama fardafldl men Bel-m um Town 1 Month I mu: 1L m. . 24m? hymn! Hlslory 2009 2010 2011 Mont: FEB MAR APR MAY JUL AUG 8EP 0t}? JAN FEB MAR APR MAY JUN JUL AUG NOV DEC JAR With KD no on - do 4 GECRBIGAPDO Experian Equ?ax 5mm Nam cameraman: Amen? 4% Awning? Current Closed ?$4594?? "mm What's missing from thla picture? PO Box 955005 ORLANDO, FL 32593 ,3 m; anl Am?! sum Cloud 96 yum Emnan . Eq ulla and Mmm?nmm Ho. Farm?! TransUniorl6 Cmdil Reports and Booms Fulth sum Paid ?Whammy at a special "Members Only? price, High arr-m $113.00 . . $124.00 Tm Ranng cm i wage Paymm History zoos 2009 2010 Month AUG esp oar NOV use me FEB MAR APR ww me JUL nun 559 nor now use area FEB MAR. APR MAY-JUN JUL Expean Personal information aspen Summary . Bankruptcies Credit haulms Credit Cards ll Loam Faye 6' $99 emu Score . 813?2?3/2814 E16: 85 561495559?. RUSF PAGE 18 ELIZABETH SAvrrT ?ew-1m {apart As Of: 3i12/2014 .mwm-w- Credit Calm, Loam Other Baht ?are you wilt ?nd speci?c Infonnatian on ?not: ammunth opened, incfuding cument status and any past due informa?nn. Fosi?w crad? Infomalion romaine an yaw sport Imannitaly, mamas: Information has baen in (smart!) make it easierforyou to 1650M CHASE :53: Experian - -- -- -- [quifex Trans?nlnn m-v-d'w} I a Account New cm; Currant Cloned ?Wm a I mm Out?t cm: GOO-9559990 Belem rm PO BOX 1529:: mm 1 hat?a cum? . DE 19350 ?"5001 Amnim? Cloud 3? your minty. EquiflxTmnsUninn? Credit Report; and gem-95 I Put! I a? spam.? ?Members only! p?ce? High animus 53,868.03 le? $11,000.00 Tm Rama? can Hm cloud-gram: mum- rtporbd by um?btr . . 2995 2005 Monaoxoxanmonoxoxoxmm'm '5 O. 9m - im=Experian~ Equifax WV WW--. Tmnsuni?" '1 A Current Cloud MN NW Cl'l?l Am"? ?5 - Amount)? amine.? Na Pram hound ?ham 1 Box 3241 What?s missing from this pictum? SIOUX FALLS, 30 57117 i fauna subway Ho i 55" Equifax?and Lug In New! Pam sum: Paid ?Emmy Transunion?9 Craft Reports and Swing mm Mace i eta spacial Members Only? pnce? um: $0.00 Tm Revolving CW Grid? l-im Mid-comm: m.qu WM bysmacribar 2W0 Pam?! History a w. A 2005 2006 2007 Month JUL MIG SEF OCT NOV DEC JAN FEB MAR APR MAY JUL AUG 35" WT ROY BEG my Jug Emma OK OK Personal information Report Bummy Credit inquires "-Cmditcams Lnam Pawn? I Cmdi! Scars PAGE 1 1 ?Wan? 813?292?2314 BE: 85 S?ldg?gm?n". RUSF ELIZABETH SAVITT (apart As Of: 311232014 Credit Carda, Lows Other Debt hate you val} find speci?c Inionnsilon on each account you opened, including current status and any past dun informalinn. Pasi?w and? information mmains on yaw apart inde?nitaiy, Cradiiorcontacl lnfonna?an has baen prowded In order to make it easier for you to resolve any issues. 1-- rmMrIv-H-vr 1 I I msxusns swarm [q uitax "franwmm: a ?2 if?? Ammum ?Engages M) Currant Cfnsad ?mms L: I 3 3mm (3de cm 590-243-8582 Mm 1 9111 DUKE BLVD Mm? an 1 What's Mia?l?g from this picture? 1 45040 a? mm . MA Ohm? ??rm Sue yourEmnan?.?qmu? and 1.05.1 In Now Pam sum: n?ahabriiy I Credit Regions and Scares MM ai a special "Members only? {met Um? mom Tm Ramw Alum! In by ?bl-mill2010 2011 2012 Mona: NOV DEC. JAN FEB MAR APR MAY JUN JUL AUG-ESP OCT NOV Dec JAN FEB MAR APR JHL AUG SEP OCT laxpemnox OK OKOKOK OH. OKDHOKOKOKIJK 01mm: OKQKOK 0K I 4. BANK OFAMERIFA :m:Exparian" mum mhn? known! Rm BANK OF ME RICA Account Account Type (3de cm Current Closer: No Phone Provde Mum p0 Box 952235 MMWE What's missing from this plenum? EL PASO. TX 79993 - Awgmm Gm Sea yaurExpenan?. Equmf? and L09 Trans LiEang Or: an Reports and seems FEW Status Paid nhhab?? High Salim 54.71100 um? $13,000.00 Tm mm Comm Cmd? line requisi- rapudad bymbacrlber at a Special "Member: Only? price. 2W0 Putnam History 2003 2004 2005 SEF OCT DEC JAN FEE MAR APR KAY JUN JUL RUG W..- Personal Information Raped Summary Credit Inquires 0mm Cams Loans Page; 6 ON Cmd? Score 261 4 85: E15 58143553 WAGE 12 VII. ELIZABETH ?ag:er toport As Of. 3112/2111 4- - Credit Garcia, Leone Other Eobt Jere you will ?nd speci?c information on each aocour? you opened, including current stem; and any past due information, Pooit?vo crodii information tannins on your sport Indonnltaly. Gmditor contact information has boon pro?dod in order to malts easier toryou to renews I .- -- {qultax IransUnion yous 1 Exponan .1, SALLIE mm 3mm Tm Edm?on Loon WW ?575-00 What's missing from was picture? PO BOX 9655 WLKES BARRE, PA 18773 mm 3? Wu.- Ewedan? am ?mol?m: 0pm: mwmom Ho. Pam! $88.00 TrIaInsLmEcinE Crodit Rayon; and Scorn: Pam-o: Mo 0mm at a special Wombats my price, High mm Unm Tums 1&0 Marthe cm BIL-domino - payment dokmd I, wanna. 24m Pawns! Emory 2012 2013 2014 Month MAR MAY Jun JUL AUG OCT NOV DEC JAN MAR APR MY JUN JUL AUG 85? OGTNOV DEG JAN FEB ND no OK-Experlon WELLS FARGO 3AM: :ij:Experian invite: ?mum or Game?! amunrmm WELLS FARGO BANK i Amour!? 1 ?Mam? ?m Wham missing from this piotum? PO Box 1451? pm Opmn? 12mm DES ?Dwainmm? Amalgam up." I See your?xporian?. Equ'faJF and Ha. Payment 510,00 TransUnion? Credit Reports and Scores Pennant 8m: cum-x at: Ipacisi?Mamban Only? once. Habitation wen) Liam noon Tm Rawhim Carmella .. 24m: Formal History 2012 2013 2016 Month MAR APR MAY JUN JUL AUG 35F OCT NOV DEC. JAN FEB MAR APR MAY JUK JUL AUG 85F HOV DEC JAN FEB ElbertPersonal Information - Ropon Summary Bankruptcies Credit Inquires Cm?! Canto 3. Loans Pow: are Crooit Boom 3 a1xzw2814 as: 85 551495?391 RESP ELIZABETH SAVITT ?mw isportAs Of; 311212014 Credit Cards, Loam Other Dam WW than you will ?nd spad?c infomatlon on each account wu opened. Including current status and any psaidua information. Posi?w credit lnfomna?cn remains on WW epod :ndannllely. Creditor contact infomlinn has been providod in order to make it easier foryou to maoM anyissuaa. 'w I - if?? . i; Jamaal Mm 1 IWJ Cum? Annual at .. .V i known! rm Flexibh Spordim can Bard ?0 WW raga": mm 5 What?s missing from ?le picture? PO Box 6241 SIOUX FALLS. SD 5711? 568 Your Emmi? and Lug in Haiti?! Amount Ml Ito. hymn: $20.00 Tta nEUnion Credit Reports and Scores Pam-m sum Oman at a apaoialembam Only? price. High Bat-m 3 mm: $2,000.93 1 rm Rama; 1 . 2mm Payment History 2012 2913 2014 MmlDEG JAN FEB MAR APR MAY JUN JUL AUG 55? 00? NOV DEC JAN OKDKOKOKOKOKOKDKOK OKOKOKOK DKOKOKDKOKOKOKOKOK 0K ?1 oll? ggmmersm Equitax n-muman Amount Nam MCYEBNB i . Amount Tm Change Account 80mm?? 5090 What's missing from this plctum? mm . . 0pm See your Emenan .Equifaaut0 and no. hymn! 55.00 TmnsUniune Cmdit Reports and Scores m' mum". Payment sum 0mm: 3 It a spacial ?Mamban Only? mice. man Baum 31.107113 Um? $100.00 rm RtvuMm Om a Fm-WV-vu - I 249%: Pawn! History 2012 2013 2014 Mona: APR RAY Jim ma 001NOV mac JAN FEB Emmi-nor: OK oxoxouox oxoxoxm cm on OK OK OK oxaxoxox'oxoxon on OK Personal Information Report Surnrnary Bankruptcies Cradit hqulres Cmc?t Cards Loans Pay 2 an Oman Score 66:85 56149553131 PQGE 14 ELIZABETH SAVITT aaport A5 or: 311212014 WIT Credit Gerda, Loono 0thor Debt - item you will ?nd speci?c infomatiun on each account you opened. including Currant status and any past duo information. Posi?ve and?! information remains on your opo? indo?n?oly. Cmditor contac?l information has been provided in orderto make i1 easier foryou to resolve anyissuos. .. v?wv -- van-?- rm .1 :aixperiaw Emilio: hous?mon swam CBNA Amr?? Account Type Hams swam Of (3de 8 8 . mas-ass mum $250,000.00 What'o missing from this picmm? Po Box 739005 mm ?mm? de 221mm 1 See yourEmenanm?qumxo and Log Now! 359390 TramsUnlorlQ Reports and Scores m'?mmumnm NW Slim: Pmdu 130 days i at a special?Momoars Only price. mob ?at-nan ?ammo i mam $250,000.00 i Tm Roma: ?mm? 2W0 Payment History 2012 2013 2014 Month APR HAY JUN JULNJO SEP 061' RON DEC JAN FEB MAR APR MAY Jim ?le0 OCT NOV DEC JAN FEE Exmrum 12:: m; 4221' 12:} m: 12:; m: w?W? CHRSE Exparjan - Emilia: Trmm?niun Ear; CWF mam Amado . umm Am"! Tm Card 5 900 an: . "559" i What's miosmg from this plcturo? PO BOX 15293 Pm a? out: We! 771/2001 DE 19869 Am?, 3m?: Cm? See you; Expan?an", Eqmai? and Log In an! lia- $16.00 TramsUnion?5 Chad]! Reports and Scores w? ?mum? ?mm: comm at a apedalWombm HM Balm mam I um 3.3mm I Tm Ran:qu cm I 2W0 Foymaot History 2014 2012 2013 MonOCT ROU DEC JAN FEB A93 MAY JUN JUL AUG 061' NOV DEC JAR FEB Emotion OK-DK OK 0K 0K 0K Personalinfonna?on ReoodSummory Bankruptcies Creditlnquiru Mama? - 81,3291?2614 65:85 561495?le RDSF 15 I ELIZABETH SAVITT 5mm 289011 A: 3122/2014 Credit lnquima dare yau wit! rind ihe names of muse who ham obtainad a oopy of your credit report, including Ienders. Iandioms and employers. Remember. inqil'?? 0" pumpm for up ta 2mm. 1 Equm hans?nian -- . y; HACYSIDSW Inquiry om mam: Mm Tm And Variety ?bre: - What?s mlsalng tram this picture? non min I 3904934552 See you! Expadane, Equlfax? and with?! 91 11 DUKE awn Transumon" Credit Reports and Scores m' m?m?mm MASON, OH 45040 at a spaciai "Members Ody? price. I I .. Personannfonnauan - Rapartaummery Bankruptcies munmurswwezorz 0mm Cardamom CmditScora 15 5: E35 561 4955:1531 RUSF ELIZABETH SAVITT ?wmw Raptor! As 01?: 311252014 - Credit Enquirie? 15"! YOU will ?nd 07 "1086 M10 haw Oblam?d capy 0! war credit report. inciuding Iendara, isndlords and amptoyers. Hemmbor. inquiries mmain on four report far up to 2 years. CITIMORTGAGE INC Emerge? Equitax Iransumnu Erwin-mm NC What's misting from this picture? lawn-yuan 11nm13 PcmmiLannCoM?n I i See your Expen?anm. Equiiax" and ?1 806-?53?3878 MD 20898 Trema?ninm0 Credit Reports and scores ata specie} "Members OW price. . . .. -1.. 1 VERIZON WIRELESS :53: Exmfian? ?rm-w- Emma; Hansuman - mm] 7 v-w I I mm Name vamzcm sameness 3' What's missing from this picture? man om 11342013 7m Wham Tahphom samba Pawns: Sea yourEmeliane. Equifax? and ?1 NWT 813-230-6292 3mm 5 Tramumone Credit Reports and Scores I 'm at a special "Members Only? price. I I . WELLS FARGO BANK 333: Experjan" -- Equlfax hans?nion .. . I . mm WELLS FARGO BANK 3' I man-yam 12mm: What's missing from this pictum? ?mm am: Cram mm 3' 877-779-5687 i . a - I 5 Seayour Expanan .Equ1fax? and 37228 TramsUninn? Ctedi! Reports and Scores M'me?mm?m i a: a specie! ?Mannsz Only" price, I 4 WELLS FARGO BANK 333 Expgrian" meta: ImnsUnicn Hm? mm Nam WELLS FARGO BANK I marry am 4mm: What'g mining from this picture? mm Type ?ank man Carma i I See your Expenanq Equifax? and {-09 1? PORRAND OR 97228 Credit Raped: and Scores I 'm at a spam: "Member: Duty" pn?ce. I Persona! lnforma?on I Bum-hazy Bankruptcies I credit {Miami ?933 of; I crud? cards Loam . clad? 3mm 31f29f2814 86:85 561495? ?2 RDSF 17 ELIZABETH SAVITT i?mw ?apart A: 01?. 311212014 um..m.wm.?H.w.m - iere you ?nd any com-related information. lnciudlng bankruptcies, state and county coma records, tax ions, and in son-Ia slates, a:me :hild support paymantt. Remember. bankruptcies remain on you: report tor 7?18 yearn. a i Public Recerda Experlan? Emilia: hans?mon ww- A Than: am: no mm on warmed?! No History i What's thi? mpa?at um. I I See your Ramadan". Equrax" and m1 TransUm?Bne Credit Repons and Scores ?m at a spaciai ?Members omy' pricePersonal Information - Raped Summary Bankruptclaa P399 5 off Cradi! Inquires - Crawl Cards Loans Cram! 3mm o1z29r2o14 86:85 561495?191 one? PAGE 13 ELIZABETH SAVITT :QgEzMn? eror'l As Of: $132014 Credir Score (our Credit Score is numerioei of your credit that is used by most lenders and credit card Issuers. Remember. Emoerien, Equifex and freneUnion has its own set of date In your credit ?le. That's why Crodi! Scores may vary between bureaus. PLUS Score: Lw w. Your PLUS Score is formulated uolng the infomelion in your credit ?le. Your PLUS Score can range between 330 and 830. with a higher score indicating a lower risk. There are many soaring module and in the marketplace. The type of score used, and its aisooieted risk levels, lender to lender. em of who! scoring mode! is used, they all have one purpose: to your creditwomdnees. Keep in mind that your more is just one factor need in the eppiceiion process. Other factors. ouch as your annual salary and length of empfoyment. may aiso be considered bylenoere mien you appry for a loan. whet this meagre to you: Credit scoring can help you understand your own! credii rating and heip companies boner understand howto serve you. Overall henelte oforedil adoring have included footer credli approvals, reduction in human error end hiee. oomieienoy, and better terms and rates 1hr American consumers Hiroth reduced more and foriendere. While lenders may use different scoring models to determine how you score. and each major oredil bmeeu has its own method for oeiculeting credit income. the eoorlng morale have been feldy we" standardized no that a score at one bureau: is roughly equivalent to the some Home at another. The PL US Scores?. developed by Exporter-i, is not an endowment or guarantee ofyour credit mn?rimoa as seen by lenders. The different risk levels preloaded here are for edmadomi use oniy. Your PLUS Soore can hob you maturation! Meat faorone impact you credit more. Please be aware that there are men; eoorlng modeie used in rho mrketpieoer and each iender?o eooriru mode? has its own so: of factors How each larder weighs their ohoeon factor: may very. bu! one exam hormone used to calculate your eoore is proprietary. In oer-norm. the higher your more. the better your cronoee ere ofootainlng hworable rates and zoom. Your Score was calculated using you aotml data from your credit ?le on the day that you {requested your report. minim oompembio to most scoring modoie inrho irrduetry. Keep in mind howevo that other lecture. such as length ofomobmd and annual eolary. are often taken into oomidora?on by render: When mining decision. about you Also note the! torch bureau here its own out of data. resulting Ina separate PLUS Score for each of your credit Moe iqui fax Personal Solutions :l/fact. econsumerequi fax.com/fact/productV1 ewehtml ?prodwcd:. .. RECEIVED OF ELDER 1. Fill AF Du SPGU FAIRS aform Completed 20?: mm '2 ?i?i 9: 09 2. Pick the reports you want Completed 3. Review your reports online Current Step 4. Get your next report or finish Completed- Repeat these steps for each credit report gave Questions? 4 Contact us Equifax Your Annual Equifax Credit Report Get Started Verify View Report Equifax understands the importance of keeping your information secure from unauthorized Eg uifax Secure?jre access. All of your data, such as your SSN and Card Number, is before being transmitted to/from our servers. For your security, this site requires the use of a 128-bit SSL compatible browser. Equifax Credit Report??M ?Beg Print This Page Save as PDP CreditSummary . Accounts In uiries . Negative Infomiatign Persons] Information Dispute File information Surmnarv of Your Rights Under the Remedying the Effects of Identity Theft weevewmw Equifax Credit Report for Elizabeth Savitt Savitt ?rst}: Report As of: 3/6/2014 qui fax Personal Sol uti ons l/facteconsumer. equi fax. comffact/productW ew .ehtml .. 03/06/2014 Available until: 04/05/2014 - Report Does Not Update Con?rmation Correct errors in your Credit Report Did you know that your free annual credit report does not include your credit score? Know where you stand by getting your credit score today. Order your Equifax Credit Score"M with this credit report for only 7.95 Note: The complete view of your credit report below will only be available during this site visit. You will have free access to your credit report-anions the historical information--for 30 days when you create an account. Credit Summary Your Equifax Credit Summary highlights the information in your credit ?le that is most important in determining your credit standing by distilling key credit information into one easy?to-read summary. Accounts Lenders usually take a positive view of individuals with a range of credit accounts - car loan, credit cards, mortgage, etc. that have a record of timely payments. However, a high debt to credit ratio on certain types of revolving (credit card) accounts and installment loans will typically have a negative impact. Debt to Accounts Open Total Credit Credit Payment with 3 Accounts Number Balance Available Limit? Ratio Amount Balance Mortgage 1 $250,000 $0 $250,000 100% $287,227 1 Installment 1 $6,575 $2,923 $9,498 69% $0 I Revolving 5 $205 $l 1,295 $11,500 2% $30 2 ?lthy: 0 $0 $0 0 Total 7 $256,780 $14,218 $270,998 95% $287,257 4 Debt by Account Type Debt to Credit Ratio by Account Type 3/6/2014 10:37 PM Equi fax Personal Solutions . Mortgage ?t 3-: Installment it Revolvin a 9 Other Total engage?97% as installment-3% Revolving?0% a Other-095 Balance Available Account Age Usually, it is a good idea to keep your oldest credit account open, as a high average account age generally demonstrates stability to lenders. Also, especially if you have been managing credit for a short time, opening many new accounts will lower your average account age and may have a negative impact. Length of Credit 12 Years: 3 Moth History Average Account 6 Years, 2 Months Age Oldest Account CHASE BANK USA. NA (Opened 07/13/2001) Most Recent (Opened 12/30/2012) Account Inquiries - Requests for your Credit History Numerous inquiries on your credit ?le for new credit may cause you to appear risky to lenders, so it is usually better to only seek new credit when you need it. Typically, lenders distinguish between inquiries for a single loan and many new loans in part by the length of time over which the inquiries occur. So, when rate shopping for a loan it's a good idea to do it within a focused period of time. inquiries in the Last 2 5 ears Most Recent Inquiry FINANCIAL MORTGAGE COMPANY (11/07/13) Potentially Negative Information Late payments, collections and public records can have a negative impact on your credit standing. The more severe and recent they are, the more negative the potential impact might be. Public. Records 0 Negative Accounts 2 Collections 1 Copyright Equifax 2014 Copyright Equifax 2014 Privacy Policy Terms of Use nlr?nn-?A qui fax Personal Solutions ://fact.eoonswner.equi ewehtm! Disclosure Information Site Map Create an account to Contact access Your Report for 39% Click here to create account 3160.014 m4? PM Savitt Guardians Elizabeth ?Betsy? aavitft 4-191 Satin Leaf Ct. Belray Beach, Fl. 33445 561-573-1292 Fax comes-1559 Dear Frankie D. Leland, I am in receipt of your letter dated in order to process and complete of?ce. November 16, 2011, requesting additional information my registration as a professional guardian with your Your inquiry concerned a notation on my credit report pertaining to a Citibank account. Please be advised that the status of this acco Palm Beach Circuit Court in Case No. 2009 aspects of the Citibank loan on my house. The past due status of this account is not court that the loan was made under impro need to reserve for court presentation, th status of this loan. Both Citibank and have lawyers workin unt is the subject of pending litigation in A 033674 in which I am contesting many due to neglect or oversight. i am asserting in per conditions and circumstances, the details at ifl am successful will negate the delinquent on this matter and we hope for a fair resolution in the near future. I have not corresponded directly with any credit agency about this matter, as it is being processed in the court. I believe that nothing about the position th negatively on my quali?cations to con information in this letter will alleviate registration. Please let me know if you need any further information. Sincerely yours, Elizabeth Savitt at have maintained in this litigation bears tinue to serve as a guardian and hope that the your concern and that you will complete my Elm! ?25% n4 212i} DEPARTMENT OF AFFAIRS STATE OF FLORIDA RICK SCOTT GOVERNOR CHARLES T. CORLE SECRETARY Statewide Pubtic Guardianship Office Yolanda L. Siples, Esq. Executive Director 4040 ESPLANADE WAY TALLAHASSEE 32399-7000 Telephone 850.414.2000 Fax 850.414.2384 TDD 850.414.2001 November 16, 201 1 Ms. Elizabeth Savitt 4101 Satin Leaf Court Delray Beach, Florida 33445 Dear Ms. Savitt: Thank you for submitting your Annual Professional Guardian Registration form to the Statewide Public Guardianship Office. As you are aware, being a guardian is an enormous responsibility. The Statewide Public Guardianship Of?ce is charged with ensuring each professional guardian as well as staff is properly quali?ed for the undertaking. One of the responsibilities of the Statewide Of?ce is to review the documentation submitted for registration. Upon review of your registration package, we noted the following areas of concern: 1. CITIBANK, Account it is over 180 days past due. Please provide an explanation for the above areas of concern and if your local court has resolved these issues, you may provide a copy of the resolution in lieu of other documentation. If you have disputed any of the above, please provide copies of your correspondence to the credit agency as well as a copy of their response. Please note we are unable to complete your registration until this issue is resolved. Please do not hesitate to contact us if you should have any questions. ii .rankie D. Leland, Operations Management Consultant 1 http://elderaffairseta te.?.us Equifax credit Reportm for Elizabeth Savitt Savitt As of: 10/22/2011 Available until: 11/21/2011 Fteport Does Not Update Confirmation ummary 0 account aCIIVtty 2. Acggrint information Detailed account information 3. Inguiries Companies that have requested or viewed your credit information 4. Negative Information Bankruptcies, iiens, garnishments and other judgments 5. Personal nformation Personal data, addresses, empioyment history 6. Dispute le information How to dispute information found on this credit report 7. Summary of Your Ridhts Under the FCRA Summary 01 Your Rights Under the FCRA 8. Remedying the ?eets of identity Theft Remedying the Effects 01 identity Theft 9. Your Rights Under State Law Your Rights Under State Law Credit Summary Your Equifax Credit Summary highiights the information in your credit file that is most important in determining your credit standing by distilling key credit information into one easy-to-read summary. Accounts Lenders usually take a positive view of individuals with a range of credit accounts - car loan, credit cards, mortgage, etc. - that have a record of timely payments. However, a high debt to credit ratio on certain types of revolving (credit card) accounts and instaliment loans wiil typicaliy have a negative impact. __ortgage 0 2 installment 3 $26,407 $0 $35,403 75 $472 3 Revolving 5 $1,006 $9,794 $10,300 9 $61 2 Other 0 $0 $0 0 Total 8 $27,413 $9,794 $46,208 59 $533 5 Debt by Account Type Debt to Credit Ratio by Account Type 0 20 40 so 60 100 Mortgage Installment Revotving Other Total Mortgage?0% installment-96% Revolving-4% 6? Other-0% NOTE: Total may not equal 100% due to rounding Account Age Usually, it is a good idea to keep your oidest credit account open, as a high average account age generally demonstrates stability to lenders. Also, especiaiiy it you have been managing credit for a short time, opening many new accounts will iower your average account age and may have a negative impact. Balance Available Length of Credit History 10 Years, 4 Months Average Account Age 5 Years, 9 Months Oldest Account CHASE BANK USA, NA (Opened 06/2001) Most Recent Account ALLY FINANCIAL (Opened 01/2011) inquiries - Requests for your Credit History Numerous inquires on your credit file for new credit may cause you to appear risky to lenders, so it is usually better to only seek new credit when you need it. Typically, lenders distinguish between inquiries tor a single loan and many new loans in part by the length of time over which the inquiries occur. So, when rate shopping for a ioan it's a good idea to do it within a focused period of time. inguiries in the Last 2 Years 18 Most Recent Inquiry HOUSEHOLD (08/02/11) Potentially Negative Information Late payments, collections and public records can have a negative impact on your credit standing. The more severe and recent they are, the more negative the potential impact might be. Public d5 0 Negative Accounts 1 ions 1 Mortgage Accounts Mortgage accounts include first mortgages, home equity loans, and any other loans secured by real estate you own. Closed Accounts 02/2006 $250,000 09/2011 PAYS AS $250,000 . . - PO Box 7901 14 Saint Louis PAYS AS AGREED individual Account. Foreclosure process started. ariable adjustable Rate I Year 201 ?l ug Sep IOct [Nov Dec v; 45?? EQIEHM 2009 2000 2007 2006 Installment Accounts instaltment accounts are credit accounts in which the amount of the payment and the number of payments are predetermined or fixed, such as a car loan. pen Accounts ALLY 01/2011 $8,734 10/2011 PAYS AS PO Box 380901 BIoomington MEN-554380901 .. ndividua! Account. :lnsta?ment 72 Months .9.-. Year Nov Dec . . 1-, . ex?. I211 SALLIE MAE 08/2008 $5,911 09/2011 $0 PAYS AS .. . I 135?}, ., 1002 Adhur Dr Haven FL-324441683 PAYS AS AGREED Joint Account 9,498 installment IN lo Student loan - payment deferred, ariable adjustabie Rate .. 0? 2010 $1 2009 2008 PAYS AS .. "6955,50 09/201 1 $11,762 11/2010 SPACE COAST CREDIT PO BOX 2470 Melbourne FL-329022470 (407} 724-5730 12119 10 Auto ndividua! AccountAug Jul Jun 1Apr May Mar Feb Jan Year .m 201 1 2010 Revolving Revofving accounts are charge accounts that have a credit limit and re cards. Open Accounts quire a minimum payment each month, such as most credit 03/2004 $0 09/201 1 PAYS AS $300 A. 9111 Duke Mason OH-450408999 (800) 243-6552 AYS AS AGREED ndividual Account. 0 evolvi redit Card ear Jan [Feb Mar Apr May Lun LEI Aug Eep Oct Nov Dec I 2011 C) 2009 2008 2007_ '3 . . ??esk? ax 2005 004 ?mazmw ,500 $8 PAYS AS AGREED 09/201 1 $65 07/2001 CHASE BANK USA, NA 51211 . :v 1123: saa?f A 43mg; - g. -1912; 15298 0'21Individuai Account. 7/2001 9/201 1 09/201 1 41 4M Wilmington Dis-19850 (800)955?9900 Dec 0V ct. lo I. .- i .mng - . 33(nu-H +4 5 .. $11k . "?\?ggt?~?3.00 3??vat? .-- . a v? 3 ?iww 3?Kay: ?a g? k" -- ramiwax?32- 1 ?x . {xii (20 PO Box 8218 Closed Accounts No 81-Month Payment Data available for display. i 03/2007 evolving $0 10/2011 PAYS AS AGREED H?m?l? .1 2006 C) 01 PO Box 182789 THE SPORTS AUTHORITY Columbus OH-432182789 veg-.131 . ?1 . ?35. 11/2001 11:2 $0 02/2002 PAYS AS AGREED ipAYs A AREE (800) 243-6552 PAYS AS AGREED I ?nk? - - Charge Account ?gigs, .n?igyi} dual Account. ivi Ind . u. g. ?11. r- it ccount closed by consumer Dec a. 0 E2: :53. xi?i? A - .. K's. .323. 35-1" 9% 12'; "Kiw- a. 3? @Segg; Ei'e??w'gt? .- C?u? - a?agE-A?\ I . . 3 $93; 9% 23%, 1433 0 ism Lk Year 291 1 2010 2009 2008 2007 000 $11 PAYSAS AGREED 12/2006 $0 06/2001 CHASE BANK USA, NA I 15298 Wiimington DE-19850 (800) 955-9900 PAYS AS AGREED 3,868 Individua! Account. .LiRiga g; 0* ?52 Credit Card $124 Credii Card Paid and Ciosed PAYS AS AGREED 09/201 1 $0 O1f2008 mg dual Account lay ccount closed at consumers request asp ndrvi evoiv 1/2008 labie ford ?tank a may . ts" No 81-Month Payment Data ava DC PO Box 985005 Orlando, FL-328965005 (800) 234-7455 (amazen C. 8725 Sahara Ave Mc 02/02/03 The Lakes NV 891630001 AGREED. 99 G) CBNA 07/2005 $0 10/201 1 PAYS AS 000 No 81-Month Payment Data available ior display. . OST OR STOLEN (800)243-6552 Mason OH-450408218 PO BOX 8218 i mgoa STOLEN CARD 03/2004 11/2010 ec 001 "k . a6 it Card $5 .8: a and Ciosed 0V PAYS AS AGREED a: Cred \a?v .5 - 5- .3va uR??gm. ?4t2;- UJ - 1.3THE HOME Sioux Falls 8067117649? 003 Gray Ops Center (800) 677-0232 PO Box 6497 Dec $300 (due every 0 Paid and Closed Charge Account . Wean PAYS AS AGREED 0 300 Cl PAYSAS AGREED . ?by; 1" v- 5 i 3?302009 Mason OH-450408999 (800) 243-6552 2008 2007 91 11 Duke 8in get: i ?i 0 af?x?; LOST OR STOLEN C3. .M 11/2010 v. . 11103/2004 ccount closed by consumer ..-. Egg?irt; ?J29' No 81 Month Payment Data avaiiabte for diSplay. Other Accounts These are all accounts that do not faii into the other categories and can inciude 30?day accounts such as American Express. You have'no accounts ciassified as ?Other? on file Payment History Key ast ue: 50-179 a set Inq nes A request for your credit history is caiied an inquiry. Inquiries remain on your credit report for two years. There are two types of inquires - those that may impact yom credit rating and those that do not. Inquiries that may impact your credit rating Tse inquires are made by companies with whom ydu have applied for a loan or credit GMAC AUTOMOTIVE BANK 01/04/11, 11/13/10 MAC A TOMOT VE BANK 6985 Union Park Midvaie, UT 840474177 (800) 200-4622 AMERICREDIT SERVICES 07/06/10 AM RICH CES \c'hv-vm 200 BAILEY AVE FORT WORTH, TX 76107 (817) 302-7424 SERVICES, INC. 12/10/10 SERVICES, INC. 444 Michigan Ave Fl 2 Sta-Consumer Detroit, MI 482262517 BB SALES FINANCE MAIN 07/06/10 A - - BB TSAL SFJNAN 101 8 Elm St Number Greensboro, NC 274012698 BRAMAN HONDA PALM BEACH 07/05/10 MAN HONDA PALM BEACH 5200 Lake Worth Rd Greenacres, FL 334633352 CAPITAL ONE 07/29/10 CAPITAL ONE 15000 Capitai One Dr Po 96766 Richmond, VA 232381119 CAPITAL ONE 07/06/10 11011 Broad St Gfen Allen, VA 230605937 CHASE BANK USA NA 06/06/10 CHASE BANK USA NA 800 Brooksedge Mailstop Westervilie, OH 430812822 CHASE CUSTOM FINANCE 07/06/10 ??gw?ggw??gg, 5mg; .8. ??an MIRAMAR CENTRE HI 3601 SW 160TH AVE. #140 IRAMAR, FL 3302? (877) 226?5663 CITEBANK OF SOUTH DAKOTA 06/20/11 - . OF 8 PO Box 6241 Sioux Fails, SD 571176241 (800) 950?51 14 THE HOME 11/23/10 THE ME 130 COS Gray Ops 541 Sid Martin Rd Gray, TN 376156210 HOUSEHOLD CREDIT SERVICES 08/02/11 HOUSEHOLD SE 2980 Meade Ave Las Vegas, NV 891020729 HSBC BEST BUY 06/19/11, 06/06/10 HSBC BEST BUY PO Box 15518 Wilmington, DE 198505518 OFF LEASE ONLY, INC. 11/11/10 .. OFF LEASE ONLY, NO. DC 3531 Lake Worth Rd Pafm Springs, FL 334614030 OFF LEASE ONLY, 01/03/11 1W OFF LEASE 3531 Lake Worth Fid Palm Springs, FL 334614030 SANTANDER AUTO 07/06/10 33635? ir-mm gassea?ipewm?ras?az sAnT NDERAUTO 8585 Stemmons Fwy Ste HOD-North Dallas, TX 752473836 inquiries that do not impact your credit rating These inquires include requests from employers, companies making promotional offers and your own requests to check your credit. These inquiries are only viewable by you. WIRELESS 04/27/11, 02/09/11, 12/22/10, 11/24/ 10 SERVICESJNC 12/10/10 06/12/1 1 FEM-CAPITAL ONE AUTO FINANCE 09/29/1 1 PRM-CAPITAL ONE 08/11/11, 06/09/11, 05/12/11, 04/07/11, 03/10/11, 02/10/11, NA 09/24/1 1 CARDS 09/08/11 CARDS CBSD 09/30/11 AR-CITIMOFITGAGE 09/06/11 EQUIFAX 10/22/1 1 10/22/11 FEM-HOUSEHOLD BANK 08/19/11, 07/22/11, 06/24/11, 05/20/11, 04/22/11, 03/22/11, 02/22/11, 01/24/11, 01/20/11, 12/27/10, 12/20/10, 11/16/10 05/03/1 1 08/16/1 1 CAPITAL, INC. 01/26/11 PRM-THE TRAVELERS INDEMITY COMPANY 01/06/11, 11/15/10 DSNB 11/05/10 inquiries with this prefix indicate that only your name and address were given to a credit grantor so they can provide you a firm offer of credit or insurance.(PRM inquiries remain for twelve months.) AM or AR inquiries with these prefixes indicate a periodic review of your credit PRM N. . l- 5. history by one of your creditors.(AM and AR inquiries remain for twelve months.) Inquiries with this prefix indicate an employment inquiry. (EMPL inquiries EMPL remain for 24 months) PR Inquiries with this prefix indicate that a creditor reviewed your account as part of a porttoiio they are purchasing.(PR inquiries remain for 12 months.) Equitax or EFX inquiries with these prefixes indicate Equifax's activity in response to your contact with us for a copy of your credit file or a research request. ND Inquiries with this prefix are generaI inquiries that do not display to credit grantors.(ND inquiries remain for 24 months.) ND MR Inquiries with this prefix indicate the reissue of a mortgage credit file containing intormation from your Equifax credit file to another company in connection with a mortgage Ioan.(ND inquiries remain for 24 months.) Negative Accounts Accounts that contain a negative account status. Accounts not paid as agreed generain remain on your credit for 7 years from the date the account first became past due leading to the current not paid status. Late Payment History generain remains on your credit fiie for 7 years from the date of the late payment. Closed Accounts CITIBANK, NA. 02/2005 $250,000 09/201 1 PAYS AS $250,000 - -. -- . PO Box 790114 Saint Louis two-631790114 PAYS AS AGREED ndividual Account. 254,642 ne of Credit 250.000 ontth (due every th) 250,000 - Foreclosure process started, ariable adjustable Ftate Year 2011 2010 2009 2007 I ?1 .. . 2006 I .n if, . .L, .51. Collections A collection is an account that has been turned over to a collection agency by one of your creditors because they believe the account has not been paid as agreed. Agency Address: 1121 Military 286 Deertield Beach, FL 334427604 (954) 428-7676 Date Reported: 01/2011 Date Assigned: 10/2010 Creditor Classification: Personal Services Creditor Name: PALM BEACH BUSHWACKERS LLC Accounts Number: Account Owner: individual Account. Original Amount Owned: $345 Date of 1 st Delinquency: 04/2010 Baiance Date: Balance Owned: $0 Last Payment Date 22/12/2010 Status Date: 01/201 1 Status: - Paid Comments: Public Records Public record information includes bankruptcies, liens or judgments and comes from federal, state or county court records. You have no Public Records on file Personal Information The following information is added to your file either when creditors enter requests to view your credit history, or when you report it to Equifax directly. Name:Elizabeth Savitt Saw? Social Security Number- Age or Date of Birth:September 9, 1955 Formerly Known As: Eiizabeth Savitt Ellis Address Information Current 4101 SATIN LEAF CT DELRAY Former Addresst 432 WOODCREST RD KEY Former AddressZ 777 SOUTH DR APT 0 DELRAY Former Address3 640 TENNIS CLUB DR FORT Former Address4 2 SOUTHMOOR DR SAINT Other Identification You have no other identification on file. Employment History Last Reported Employment: SELF TENNIS AVALON ESTATES Previous Employment(s): SELF TENNIS PROLESS: AVALON ESTATES Alert(s) You have no Alerts on file. Consumer Statement You have no Consumer Statement on file. Dispute File Information i If you believe that any of the information information on this report. When you file a dispute, the credit bureau you contact is required to investigate your dispute within 30 days. They will not remove accurate data unless it is outdated or cannot be verified. To initiate a dispute oniine please visit To check the status or view the results of your dISpute please visit How to order your score by phone By law, you are entitled to obtain your credit score. There is a fee of $7.95 to obtain your credit score from Equifax Information Services . To request your credit score, please contact: .d on this report is incorrect, there are 3 ways .aunch an investigation about the Equifax information Services LLC PO. Box 105167 Atlanta, GA 30348 or call If you are in the process of obtaining a mortgage, you may be entitled to free credit score information. Contact the person making or arranging your loan for further information. A Summary of Your Rights Under the Fair Credit Reporting Act The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records).Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to or write to: Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Ave. N.W., Washington, D.C. 20580. - You must be told if information in your file has been used against you. Anyone who uses a credit file or another type of consumer file to deny your application for credit, insurance, or employment - or to take another adverse action against you must tell you, and must give you the name, address, and phone number of the agency that provided the information. - - You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your ?file disclosure?). You will be required to provide proper identification, which may include your Social Security number. in many cases, the disclosure will be free. You are entitled to a free file disclosure if: - a person has taken adverse action against you because of information in your credit file; a you are the victim of identity theft and place a fraud alert in your file; it your file contains inaccurate information as a result of fraud; you are on public assistance; 0 you are unemployed but expect to apply for employment within 60 days. in addition, by September 2005 all consumers will be entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See Witcgovzcredit for additional information. - You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender. - You have the right to dispute incomplete or inaccurate information. if you identity information in your file that is incomplete or inaccurate, and file it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See for an explanation of dispute procedures. - Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to file information it has verified as accurate. Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.[Equifax Note: Negative information is generally considered delinquent or derogatory accounts on a file disclosure. On an Equifax file disclosure, the seven year time period begins from the Date of First Delinquency associated with the negative account information. For more information about the date of first delinquency, please visit the Frequently Asked Questions section of Equifax?s website located at equifax. com] I Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access. - You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to You may limit "prescreened" offers of credit and insurance you get based on information in your credit file. Unsolicited "prescreened" offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt-cut with the nationwide credit bureaus at (1-888-567-8688). able to sue in state or federal court. You may seek damages from violators. if a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be Identity theft victims and active duty military personnel have additional rights. For more information, visit States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. Federal enforcers are: TYPE OF BUSINESS: CONTACT: Consumer reporting agencies, creditors and others not listed below Federal Trade Commission: Consumer Response Center - FCRA Washington, DC 20580 1-877?382-4357 National banks, federal branches/agencies of foreign banks (word "National" or initials appear in or after bank's name) Office of the Comptroller of the Currency Compliance Management, Mail Stop 6-6 Washington, DC 20219 800-613-6743 Federal Reserve System member banks (except national banks, and federal branches/agencies of foreign banks) Federal Reserve Board Division of Consumer 8 Community Affairs Washington, DC 20551 202-452-3693 Savings associations and federally chartered savings banks (word "Federal" or initials appear in federal institution's name) Office of Thrift Supervision Consumer Complaints Washington, DC 20552 800-842-6929 Federal credit unions (words "Federal Credit Union" appear in institution's name) National Credit Union Administration 1775 Duke Street Alexandria, VA 22314 703?519-4600 State-chartered banks that are not members of the Federal Reserve System Federal Deposit insurance Corporation Consumer Response Center, 2345 Grand Avenue, Suite 100 Kansas City, Missouri 64108?2638 1-877-275-3342 Air, surface, or rail common carriers regulated by former Civil Aeronautics Board or Interstate Commerce Commission Department of Transportation Office of Financial Management Washington, DC 20590 202?366-1306 Activities subject to the Packers and Stockyards Act, 1921 Department of Agriculture Office of Deputy Administrator - Washington, DC 20250 202-720-7051 Remedying the Effects of Identity Theft Identity theft occurs when someone uses your name, Social Security number, date of birth, or other identifying information, without authority, to commit fraud. For example, someone may have committed identity theft by using your personal information to open a credit card account or get a loan in your name. For more information, visit or write to: FTC, Consumer Response Center, Room 130-8, 600 Avenue, NW. Washington, DC, 20580. The Fair Credit Reporting Act (FCRA) gives you specific rights when you are, or believe that you are, the victim of identity theft. Here is a brief summary of the rights designed to help you recover from identity theft. 1. You have the right to ask that nationwide consumer reporting agencies place "fraud alerts" in your file to let potential creditors and others know that you may be a victim of identity theft. A fraud alert can make it more difficult for someone to get credit in your name because it tells creditors to follow certain procedures to protect you. it also may delay your ability to obtain credit. You may place a fraud alert in your file by calling just one of the three nationwide consumer reporting agencies. As soon as that agency processes your fraud alert, it will notify the other two, which then also must place fraud alerts in your file. Equifax: 1-800-525-6285; Experian: 1-888-397-3742; - TransUnion: 1-800-680-7289; An initial fraud alert stays in your file for at least 90 days. An extended alert stays in your file for seven years. To place either of these alerts, a consumer reporting agency will require you to provide appropriate prooi of your identity, which may include your Social Security number. If you ask for an extended alert, you will have to provide an identity theft report. An identity theft report includes a copy of a report you have filed with a federal, state, or local law enforcement agency, and additional information a consumer reporting agency may require you to submit. For more detailed information about the identity theft {y .. report, visit 2. You have the right to tree ceples of the information in your file (your "file disclosure"). An initial fraud alert entitles you to a copy of all the information in your file at each of the three nationwide agencies, and an extended alert entitles you to two free file disclosures in a 12-month period following the placing of the alert. These additional disclosures may help you detect signs of fraud, for example, whether fraudulent accounts have been opened in your name or whether someone has reported a change in your address. Once a year, you also have the right to a free copy of the information in your file at any consumer reporting agency, if you believe it has inaccurate information due to fraud, such as identity theft. You also have the ability to obtain additional free file disclosures under other provisions of the See 3. You have the right to obtain documents relating to fraudulent transactions made or accounts opened using your personal information. A creditor or other business must give you copies of applications and other business records relating to transactions and accounts that resulted from the theft of your identity, if you ask for them in writing. A business may ask you for proof of your identify, a police report, and an affidavit before giving you the documents. It also may Specify an address for you to send your request. Under certain circumstances, a business can refuse to provide you with these documents. See 4. You have the right to obtain information from a debt collector. if you ask, a debt collector must provide you with certain information about the debt you believe was incurred in your name by an identity thief like the name of the creditor and the amount of the debt. 5. if you believe information in your file results from identity theft, you have the right to ask that a consumer reporting agency block that information from your life. An identity thief may run up bills in your name and not pay them. information about the unpaid bills may appear on your consumer report. Should you decide to ask a consumer reporting agency to block the reporting of this information, you must identify the information to block, and provide the consumer reporting agency with proof of your identity and a copy of your identity theft report. The consumer reporting agency can refuse or cancel your request for a block if, for example, you don?t provide the necessary documentation, or where the block results from an error or a material misrepresentation of fact made by you. If the agency declines or rescinds the block, it must notify you. Once a debt resulting from identity theft has been blocked, a person or business with notice of the block may not sell, transfer, or place the debt for collection. 6. You also may prevent businesses from reporting information about you to consumer reporting agencies it you believe the information is a result of identity theft. To do so, you must send your request to the address specified by the business that reports the information to the consumer reporting agency. The business will expect you to identify what information you do not want reported and to provide an identity theft report. To learn more about identity theft and how to deal with its consequences, visit or write to the FTC. You may have additional rights under state law. For more information, contact your local consumer protection agency or your state attorney general. In addition to the new rights and procedures to help consumers deal with the effects of identity theft, the has many other important consumer protections. They are described in more detail at Your Rights Under State Law Florida the Right to, Elacg a ?gcurity Freeze You have a right to place a "security freeze" on your consumer report, which will. except as provided by law, prohibit a consumer reporting agency from releasing any information in your consumer report without your express authorization. A security freeze must be requested in writing by certified mail to a consumer reporting agency. The security freeze is designed to prevent credit, loans, and services from being approved in your name without your consent. YOU SHOULD BE AWARE THAT USING A SECURITY FREEZE TO CONTROL ACCESS TO THE PERSONAL AND FINANCIAL INFORMATION IN YOUR CONSUMER REPORT MAY DELAY, WITH, OR PROHIBIT THE TIMELY APPROVAL OF ANY SUBSEQUENT REQUEST OR YOU MAKE REGARDING A NEW LOAN, CREDIT, MORTGAGE, INSURANCE, GOVERNMENT SERVICES OR PAYMENTS, RENTAL HOUSING, EMPLOYMENT, INVESTMENT, LICENSE, CELLULAR PHONE, UTILITIES, DIGITAL SIGNATURE, INTERNET CREDIT CARD TRANSACTION, OR OTHER SERVICES, AN EXTENSION OF CREDIT AT POINT OF SALE. When you place a security freeze on your consumer report, you will be provided a personal identification number or password to use it you choose to remove the freeze on your consumer report or authorize the release of your consumer report fora designated period of time after the security freeze is in place. To provide that authorization, you must contact the consumer reporting agency and provide all of the following: 1. The personal identification number or password. r- 2. Proper identification to verify your ident. 3. information specifying the period of time for which the report shall be made available. 4. Payment of a fee authorized by this section. A consumer reporting agency must authorize the release of your consumer report no later than 3 business days alter receiving the above information. A security freeze does not apply to a person or entity, or its affiliates. or collection agencies acting on behalf of the person or entity, with which you have an existing account, that requests information in your consumer report for the purposes of reviewing or collecting the account. Reviewing the account includes activities related to account maintenance, monitoring, credit line increases, and account upgrades and enhancements. You have the right to bring a civil action against anyone, including a consumer reporting agency, who fails to comply with the provisions of s. 501.005, Florida Statutes, which governs the placing of a consumer report security freeze on your consumer report. A security freeze request must be mailed via certified mail to: Equifax Security Freeze PO. Box 105788 Atlanta, Georgia 30348 Or, you may contact us on the web at equifaxcom or call 800-685-1111. The fee to place a security freeze is $10.00. It you are a victim of identity theft and you submit a copy of a valid investigative or incident report or complaint with a law enforcement agency about the unlawful use of your identifying information by another person, no fee will be charged. If you are sixty-five years of age or older, no fee will be charged. include your complete name, complete address, social security number, date of birth and payment, if applicable. Written confirmation of the security freeze will be sent within 10 business days of receipt of the request via first class mail. It will include your unique personal identification number and instructions for removing the security freeze or authorizing the release of your credit report for a Specific period of time. Equifax otters you personal credit products that enlighten, enable and empower you. Whether you are managing your credit, protecting your identity or preparing for a major purchase, Equitax offers the tools you need to make the smartest choices possible. For more information visit 'l?ransUnion A Page i of 7 File Number: 21902151 Date looked: 04/052010 Home: ELIZABETH S. SEN: Date o! Birth: DBIIQSS other Names: BEFSY 5. ELLIS Telephone 496:1559 ELIZABETH S. ELLIS You have been on our ?les since 04,!1900 Your SSN is partially masked for your protection PREVIOUS ADDRESSES CURRENT ADDRESS Address: 4101 SATIN LEAF CT. Address: 40101 SATIN LEAF cr. ostrw BEACH, FL 33445 DELRAY BEACH, Fl. 33445 Date Reported: 02:2005 Date Reported: 01/2003 Address: mi soon: OR, at: DELRAY BEACH, FL 33445 EMPLOYMENT DATA REPORTED Employer Name: SAVITT TENNIS MAINTENANCE AMP Poe ltlon: Date Reported: 01/2006 Date aired: TENNIS PRO Special Notes: Your Social Security number has been masked for your protection. You may request disclosure of the fuii number by writing to us at the address found at the end of this report. Also if any item on your credit report begins with it includes medics! information and the data following is not displayed to anyone but you except where permitted by law. air? or to The lcey to the right helps explain the payment history information contained in some of the accounts beiow. Not all accounts will contain payment history information, but some creditors Unknown (?new 60 daw '90 days late late report how you make payments each month in relation to your agreement with them. pl. AD stable late late The following accounts contain information that some creditors may consider to be adverse. Adyerse account information may generain be reported for 2 years from the date of the first delinquency, depending on your state of residence. The adverse information in these amounts has been printed in >bracitets< or is shaded for your convenience, to help you understand your report. They are not bracketed or shaded this way for creditors. (Note: The account i? may be scrambled by the creditor for your protection). CITIBANK NA #1 Balance: $250,000 Pay Status: >120 Days Past Due< LOSUSOLTHNOLOGY DR Date Updated: D3f2010 Account Type: Line of Credit Account MO 63368-2240 High Balance: $254,642 Individual Account 53543935 Credit Limit: $250,000 Date Opened: 02/2006 Past Due: b$10,330< Terms: Minimum $52? Loon Type: Home Equity Loan Remark: >Foreciosure initiated< >Maximum delinquency of 120+ days in 03l2009 for 53,5684 Estimated date that this item tell! he removed: 13(2015 Late Payments or out sop an; int jun me; an: rear 1 48 months ?9 oat snap to: gut for: apt mar Heaths ole al3< The following acoounts are reported with no adverse information. (Note: The account it may be Scrambled by the creditor for your protection). CHASE BANK USA NA #i alliance: $40 Pay Status: Paid or Paying a5 Agreed 300 BROOKSEDGE BLV . WESTERWLLE OH 43081 Date Updated: 031?2'3 10 Account type: Revolving (800) 436-7030 Balance: $5.389 Responsibility: individual account Credit Limit: $3,500 Date Opened: 02/2001 Past Due: $0 Terms: Minimum ?49 0133? 20 2011 mi: 313 H- tool: Type: Credit Card Late Payments 4/5/2010 Filo rm CGC Hem RESULT 3P2690 5% 67"? no 87360 00 Hi?? gacnm ?760,726? tom 20- are NCG Lisa Hodgins 659 107972010 Pass 107972010 28-Aug?10 Paim Harbor. FL 276778 659 107972010 Pass 107972010 20- NCG Melba Keiiy 660 107972010 Pass 107972010 28-Aug-10 Palm Harbor, FL 276778 660 107972010 Pass 107972010 20- NCG Meiba Keily 660 107972010 Pass 107972010 28-Augn10 Palm Harbor. FL 276778 660 107972010 Pass 107972010 20? NCG Teresa Lyman 661 107972010 Pass 107972010 28-Aug-10 Palm Harbor. FL 276778 661 107972010 Pass 107972010 20? NCG Teresa Lyman 661 107972010 Pass 107972010 28?Aug-10 Palm Harbor, FL 276778 661 107972010 Pass 107972010 20- NCG Laura Parrish 662 107972010 Pass 107972010 26?Jun?10 St. Petersburg Coiiege 201204 662 107972010 Pass 107972010 20- NCG Laura Parrish 662 107972010 Pass 107972010 26-Jun-10 St. Petersburg College 201204 662 107972010 Pass 107972010 20- NCG Carol Steeves 664 107972010 Pass 107972010 28-Aug-10 Palm Harbor, FL 276778 664 107972010 Pass 107972010 20- NCG Carol Steeves 664 107972010 Pass 107972010 28-Aug-10 Palm Harbor. FL 276773 664 107972010 Pass 107972010 20? Jane Vatelot 665 107972010 Fail 26-Jun-10 St. Petersburg Coilege 201204 665 107972010 Pass 107972010 20? Jane Vateiot 665 107972010 Faii 26-Jun?10 St. Petersburg College 201204 665 107972010 Pass 107972010 Guardian Angel 20- .James R. Boates 0675A 1171472010 Fail 28-Aug-10 Services 259815 0675A 1171472010 Fail 117147201 Guardianship Training 8 20? NCG Roxanne Cumberiand 06778 1171472010 Pass '0 26-Sep-10 Support Services 278031 06778 1171472010 Pass 1171472010 117147201 Guardianship Training 8: 20- NCG JoAnne McNamara 06780 1171472010 Pass 0 11~Jui-10 Support - Kenney 265418 0678C 1171472010 Pass 1171472010 117147201 . Guardianship Training 20- Savitt 06793 1171472010 Pass 0 1:19-Jui-103" 8 Support Services 265418 06793 1171472010 Pass 1171472010 . 117147201 Guardianship Training 20? NCG Swerdiin 0680C 1171472010 Pass 0 26-Sep-10 Support Services 278031 06800 1171472010 Pass 1171472010 117147201 Guardian Angel 20? NCG D. Szuba 0681A 1171472010 Pass 0 28~Aug-10 Services 259815 0681A 1171472010 Pass 1171472010 117147201 20- 1196 Vea Townsend 06830 1171472010 Pass 0 28-Aug?10 Palm Harbor, FL 276778 06830 1171472010 Pass 1171472010 . 20- Ronnie E. Townsend 06828 1171472010 Fail 28-Aug-10 Palm Harbor. FL 276778 06823 1171472010 Faii 20- Jerry Beauchamp 0693A 1172072010 Fail 28-Aug-10 Pat Wood - Ocaia. FL 204403 0693A 1172072010 Fail 20- Denice M. Biand 06948 1172072010 Fail 28-Aug-10 Pat Wood 204403 06948 1172072010 Faii 1172072010 117207201 Karen Campbell. 20- NCG Jon D. Freisen 0696A 1172072010 Pass 0 24-Sep-10 Taliahasse, FL 275287 0696A 1172072010 Pass 117207201 Guardian Angel 20- NCG Jade Maiek 06978 1172072010 Pass 0 28-Aug-10 Services 259815 0697B 1172072010 Fail 1172072010 117207201 20- NCG Jeannie E. Martin 06980 1172072010 Pass 0 28-Aug-10 Pat Wood 204403 0698C 1172072010 Pass 1172072010 CE Broker I Transcript Page 1 of 1 License Transcript Name SAVITT Transcript Name PG, Standard {even year} Required FLORIDA STATEWIDE PUBLEC GUARDIANSHIP OFFICE Completion Date 12i31i2016 Days Remaining 842 Transcript Dates 011012'2015 - 12(31i2016 Printed Date 30-MAR-2015 SubjectAN??a 23:3?? 23:5; 3223; Continuing Education 16 13 3 GUARDIANSHIP 101 01i08i2015 ?i PROFESSIONAL GUARDIAN ETHICS-DUTY OF LOYALTY 02i06i2015 2 SOCIAL SECURITY EXPLAINED O2i10i2015 2 PATHOGENS 4 OVERCOMING OF DEMENTIA 2012 03i04a?2015 4 Total Hours: 18 13 3 3/ 3 0/201 5 CE Broker] Transcript Page 1 of 1 License Transcript Name ELIZABETH SAWTT Transcript Name PG, Standard {even year) Required FLORIDA STATEWIDE GUARDIANSHIP OFFICE Commetion Date 12l31!2014 Days Remaining -89 Transcript Dates O1f01f2013 - 1213112014 Printed Date 30-MAR-2015 Subimrea 22:22? 3235; Continuing Education 16 3 13 BJEQLAR DISORDER 04l24f20?l3 2 DISEASE 301 AND RESEARCH UPDATE 09/121?2013 ?3 Total Hours: 16 3 13 .. 3/3 0/20] 5 CE Broker I Transcript Page 1 of 1 License Transcript Name ELIZABETH SAVITT Transcript Name PG, Standard {even year} Required FLORIDA STATEWIDE PUBLIC GUARDIANSHIP OFFICE Compietion Date 12131I2012 Days Remaining -819 Transcript Dates - 128112012 Printed Date 30-MAR-2015 . Hours Hours Hours same? Area Required Posted Needed Continuing Education 16 20 0 PARTERING WITH FAMILY GUARDIANS 02:09/2012 1 PROTECTING GUARDIANSHIP ASSETS: HOW TO IDENTIFY 1 FRUAD, WASTE FINANCIAL MISMANAGEMENT HOARDING IN LATER-LIFE 06H4f2012 1 25TH ANNUAL FSGA CONFERENCE 2012 STRUCK 07!,219012 RULES AND REGULATIONS OF THE FUNERAL AND CEMETERY INDUSTRIES 09? 3/2012 7 AREA AGENCY ON AGING - WHAT 18 THE AGING 101,1?2012 1 RESOURCE CENTER WORKING WITH FAMILIES OF PERSONS WITH SERIOUS MENTAL ILLNESS 1212012 2 ETHICS AND THE PROFESSIONAL GUARDIAN 1325;2012 4 Excess Hours no! applied: 4 Total Hours: 16 20 0 3/30/20] 5 Eemer for Guardianship Eerri?cariou Hm; $3 inrrirt?hum In tin Prwam?z'zgg l?ngf?m?z'zwa? I Elizabeth ?Betsy? Savitt has been certi?ed as a National Certi?ed Guardian by the Center for Guardianship Certi?cation I. The mission of the Center for Guardianship Certi?cation (COG) is idcu tit-yng those individuals who are involved in guardianship .i guardianship services to be to promote the guardianship certi?cation program by ssues and win") meet levels of knowledge and expertise in identi?ed to the public as a National! Certi?ed (fluardian (NFC). ?1 - I I (.ommittee Chairperson 1"re31dent November 30, 2012 Expiration Date